Co-designing whānau stories to reduce opioid use for chronic pain in Aotearoa

Dr Debbie Bean is one of the interdisciplinary group of researchers working to develop creative ways to help opioid tapering for people with chronic pain in Aotearoa.

The kaupapa (purpose) of their mahi (work) is to create a whānau-focused storytelling intervention to support people with chronic non-cancer pain to gradually reduce or cease opioid use. Lead out of the University of Otago by Co-Principal Investigators Hemakumar Devan (at the University of Otago) and Cheryl Davies (Tu Kotahi Asthma Trust), this project aims to co-produce a story-based, whānau-focused opioid tapering intervention for people with chronic non-cancer pain, and to evaluate the clinical implementation of this story-telling intervention in four tertiary pain services (Wellington, Auckland, Counties-Manukau and Waitemata) and four primary care practices.

Opioids are commonly used in pain relief for chronic, non-cancer pain. Although potentially beneficial in the short term, long-term use risks include dependency, reduced function and early mortality. Māori adults have the highest rates of strong (prescription) opioid use, suggesting inequities associated with opioid use. Clinical guidelines recommend opioid tapering (ie, from gradual reduction to cessation). However, opioid tapering is extremely challenging for both patients and clinicians.

With significant inequities for Māori, culturally responsive strategies from a te ao Māori worldview are urgently needed. Pūrākau (a form of Māori narrative) are powerful tools that can influence behaviour. The need for whānau stories has been informed by a previous HRC project to develop a digital pain management programme (iSelf-help). Whānau enjoyed sharing their experiences of pain management with other whānau via short video stories. Digital story-telling interventions (ie, video stories) have been previously culturally adapted for Māori.

Thus, stories of people with chronic pain who have successfully tapered their opioid medication may be powerful tools to motivate others to begin and persist with opioid reduction. With no primary research in Auckland, New Zealand on opioid tapering, urgent attention is needed for effective, culturally sensitive interventions.

Related resources

Study website (whanaustories)