Objective  The aim is to understand the common scenarios of non-medical use of prescription opioids (NMUPO) and analyze the potential facilitating and hindering factors in the regulatory process of NMUPO from the perspective of healthcare professionals.

Methods  Healthcare professionals in local hospitals were surveyed through a two-stage purposive sampling from June to August 2022 in Ningbo, China. The survey was conducted using a semi-structured questionnaire on topics, and thematic analysis were used to identify and summarise key themes and patterns.

Results  A total of 75 participants were included, the average age was (43.9±7.2) years, and 54 (72.0%) were male. The most common NMUPO scenarios involved middle-aged males pretending acute severe pain to obtain injectable opioids. The facilitating and hindering factors related to the regulation of NMUPO can be categorized into three types: institutional governance, technical support, and individual behaviors. At the institutional level, facilitating factors included strict national prescribing policies and local "narcotic drug card" systems, while barriers comprised incomplete lists of controlled substances. At the technological support level, facilitating factors included the establishment of regional health information platforms, while barriers included the lack of standardized prescription guidelines and diagnostic decision-support tools. At the individual level, facilitating factors included the public’s cautious attitude toward drug misuse, while barriers included strained doctor-patient relationships.

Conclusion  China still faces significant challenges in addressing NMUPO and urgently needs to improve the existing regulatory system. It is recommended that reforms be carried out in areas such as pharmaceutical control mechanisms, drug treatment and rehabilitation services, preventive health education activities, and the optimized use of health information systems.

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