Purpose: In view of concerns about the harmful effects of long-term use and patient misuse of opioids in chronic non-malignant pain, this study provides insight into patients’ perspectives on their experience of living with chronic non-malignant pain (CNMP), prescribed opioid use, and optimisation. Patients and Methods: Data were collected from active UK-based CNMP specific or general health forums that do not require registration, with more than 100 members. English written thread posts between 2016 and 2020 were systematically searched from the forum search bar using different keywords and then analysed using the Theoretical Domains Framework (TDF). Results: Findings showed that chronic pain is a dominant, life-altering experience with physical, psychological and social impact. Findings highlighted that opioid optimisation is facilitated by patients’ knowledge and understanding, practical coping strategies and supportive relationships with healthcare providers and others in their surroundings. The study found that barriers to opioid optimisation included lack of availability of alternatives, difficulties accessing health services and broken relationships with clinicians. Conclusion: Analysis of CNMP patients’ posts on online forums highlighted the devastating impact of pain on social functioning, relationships and mental health. Patients emerged as knowledge seekers prepared to engage in opioid optimisation.

Background: The use of opioids for chronic non-malignant pain (CNMP) offers limited efficacy and carries the potential for addiction. Healthcare professionals in both primary and secondary care settings face challenges when attempting to optimise opioid medications. There are limited studies that investigated the barriers and enablers to opioid reduction, cessation, and optimisation, specifically from a pain clinical specialist perspective. Objective: This study explores pain clinical specialists’ views on challenges in opioid prescription management—including optimization and tapering—and their interactions with patients and prescribers. Methods: Participants were recruited through pain clinic, webinars Email outreach, and professional networks. Semi-structured interviews were conducted using a guide based on the Theoretical Domains Framework (TDF) with 11 pain clinical specialists (8 consultants and 3 pharmacists) from NHS England, out of 15 participants who initially expressed interest, recruited via professional networks. Thematic analysis employed Framework Approach with dual coding. Key Findings: Eleven participants, comprising eight pain doctors and three clinical pharmacists, provided insights. Analysis revealed four key findings: (1) A paradigm shift away from long-term opioid therapy due to concerns about dependency and inadequate pain relief; (2) Strong preference for multidisciplinary, personalized treatment approaches; (3) Significant system-level barriers including care fragmentation and inadequate consultation time; (4) Critical need for enhanced clinician training and patient education programs. Conclusion: Optimizing opioid use for CNMP requires fundamental changes to current practice, including implementation of integrated care pathways, extended consultation times, and comprehensive education initiatives. These findings provide evidence-based recommendations for improving pain management while reducing inappropriate opioid prescribing.

Background/Objectives: Chronic non-malignant pain (CNMP) affects 46.4% of adults in Saudi Arabia and often requires interdisciplinary care, including mental health services. Despite this need, mental health integration remains limited. This study explored healthcare providers’ perceptions of integrating mental health services into CNMP management and identified barriers and facilitators to interdisciplinary collaboration. Methods: A cross-sectional survey was conducted among 114 healthcare providers across Saudi Arabia. Using the Theoretical Domains Framework (TDF), domains such as knowledge, skills, beliefs about capabilities and consequences, reinforcement, and social influences were assessed. Data were analyzed using descriptive statistics, correlation analyses, and multiple regression. Results: Positive perceptions of mental health integration were significantly associated with beliefs about capabilities (r = 0.31, p = 0.001) and beliefs about consequences (r = 0.40, p < 0.001), as well as skills (r = 0.30, p = 0.001) and reinforcement (r = 0.26, p = 0.005). Multiple regression confirmed beliefs about capabilities (B = 0.208, p = 0.001) and consequences (B = 0.237, p < 0.001) as independent predictors, explaining 31.9% of the variance in perceptions (R² = 0.319, adjusted R² = 0.285). Emotional responses, such as stress, were potential barriers but did not independently predict perceptions. Systemic challenges included limited referral pathways and insufficient mental health resources. Conclusion: Confidence in professional abilities and recognition of the benefits of collaboration are key drivers of positive perceptions toward mental health integration in CNMP care. Interventions that enhance provider confidence, emphasize interdisciplinary benefits, and strengthen organizational support may improve engagement with mental healthcare services in Saudi Arabia.