• Crystal Lederhos Smith, Billie Severtsen, Roxanne Vandermause, Celestina Barbosa-Leiker, Marian Wilson, and John Roll.
• College of Nursing, Washington State University, Spokane, Washington; Program of Excellence in Addictions Research, Washington State University, Spokane, Washington; Translational Addiction Research Center, Washington State University, Spokane, Washington. Electronic address: crystal.lederhos@wsu.edu.
• Pain Manag Nurs. 2018 Dec 1; 19 (6): 652-662.

BackgroundIn the United States, chronic pain is experienced by over 39.4 million adults, many of whom are treated with opioid pain medications.AimThis research presents an interpretation of the experience of seeking pain relief for a group of people taking opioid pain medications whose pain is not adequately controlled.MethodsA concurrent embedded mixed-methods design was used, including a Heideggerian hermeneutic qualitative approach that focuses on the participants' perceptions as a vehicle for understanding the phenomenon of seeking pain relief with descriptive quantitative data in a supporting role. Thirteen interviews and 15 surveys were analyzed, all of which met the following criteria: (1) self-reported chronic pain (persistent pain lasting a minimum of six months), (2) current use of prescription opioid medications, (3) pain not successfully controlled.ResultsThe analysis revealed a paradox, which we describe as being lost/finding myself in the health care system. This paradox became the overarching pattern of experience that subsumed several dynamic, overlapping practices described in the patterns: (1) seeking relief as suffering; (2) being classified as an addict but not an addict; (3) living with pain as remembering; and (4) experiencing treatment modalities as fickle possibilities.ConclusionExplication of and interpretive commentary on these patterns shift the focus from drug seeking to pain relief seeking behaviors in chronic pain sufferers. Such a shift could change the manner in which providers work with chronic pain sufferers to find appropriate treatment modalities.Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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