Lived experience of the non-medical use of tramadol among people in Ghana: an interpretative phenomenological analysis.

Owusuaa-Asante, Maame Ama

Abstract

The non-medical use of tramadol, a prescription opioid medication, is a global health issue associated with severe physical, mental and social consequences. Several studies have examined the contributing factors and social consequences of the problem in Ghana. However, notable gaps remain in existing qualitative studies exploring the complexities of the phenomenon. Moreover, the paucity of research on existing rehabilitation and support programmes for tramadol use in Ghana further accentuates these gaps. The main aim of this thesis was therefore to gain an in-depth understanding of the complexities and lived realities of the non-medical use of tramadol in Ghana. A scoping review was conducted to map and summarise the available evidence on contributing factors, social effects, rehabilitation and support for the non-medical use of tramadol, and to identify gaps in the international evidence base. To address some of the identified gaps, an Interpretative Phenomenological Analysis was employed to explore the lived experience of sixteen individuals with a history of tramadol use in Ghana. Participants were purposively sampled for audio-recorded individual face-to-face semi-structured interviews at drug rehabilitation and support facilities in Kumasi and Accra. Audio-recorded interviews were simultaneously transcribed and translated, and then analysed using the foundational principles and procedures of the IPA methodology. Four superordinate themes emerged during the data analysis: (i) Precursors and influences of the non-medical use of tramadol; (ii) Socio-cultural, environmental and knowledge factors contributing to the continuous non-medical use of tramadol; (iii) Multifaceted consequences of the non-medical use of tramadol, and (iv) The complex framework of the rehabilitation process and its role in facilitating recovery from the non-medical use of tramadol. Within the broad superordinate themes, are subordinate themes and subcategories that offer specific and nuanced details of the overarching themes. The findings illuminate the interplay of individual and social contexts in influencing initial use of tramadol. They elucidate the role of awareness, perceptions, cognitive processes, societal norms, cultural expectations and drug accessibility in the continuous use of tramadol. Furthermore, the findings indicate that the consequences of tramadol use have a cascading effect, impacting individuals and reverberating across the wider societal context. The consequences include interpersonal problems, social isolation, educational disengagement, and a negative impact on emotional, financial and community well-being. The analysis reveals that rehabilitation for tramadol use is complex, involving multifaceted approaches that include medical, psychological and social dimensions. The rehabilitation process emerged as a critical component in facilitating recovery through addressing individuals' holistic needs and assisting them in achieving long-term positive outcomes. Collectively, these findings demonstrate the complex interaction between individual, social, cognitive and environmental factors that shape the trajectory of tramadol use and its potential recovery process. The study emphasises the need for a comprehensive, multi-disciplinary, and holistic approach to address the complexities of the non-medical use of tramadol. The proposed approach should encompass a spectrum of strategies, from prevention to rehabilitation, considering individual and societal contexts. The study's findings indicate the need for tailored interventions that acknowledge the multi-dimensional impact of tramadol use to achieve sustainable, long-term recovery.

Citation

OWUSUAA-ASANTE, M.A. 2024. Lived experience of the non-medical use of tramadol among people in Ghana: an interpretative phenomenological analysis. Robert Gordon University, PhD thesis. Hosted on OpenAIR [online]. Available from: https://doi.org/10.48526/rgu-wt-2571253

• Thesis Type: Thesis
• Deposit Date: Nov 5, 2024
• Publicly Available Date: Nov 5, 2024
• DOI: https://doi.org/10.48526/rgu-wt-2571253
• Keywords: Tramadol; Opioids; Drug abuse; Drug abuse and society; Rehabilitation; Ghana
• Public URL: https://rgu-repository.worktribe.com/output/2571253
• Award Date: May 31, 2024