• Pain Manag Nurs · Apr 2021

    Pain and Barriers to Accessing Health Services Among People Who Use Drugs.

    • Pauline Voon, Linwei Wang, Ekaterina Nosova, Kanna Hayashi, M-J Milloy, Evan Wood, and Thomas Kerr.
    • British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: pauline.voon@bccsu.ubc.ca.
    • Pain Manag Nurs. 2021 Apr 1; 22 (2): 133-140.

    BackgroundThe opioid overdose crisis underscores the need for health services among people who use drugs (PWUD) with concurrent pain.AimsInvestigating the effect of pain on barriers to accessing health services among PWUD.DesignProspective cohort study.SettingsA setting of universal access to no-cost medical care in Vancouver, Canada from June 2014 to May 2016.Participants/SubjectsPWUD who completed at least one study interview.MethodsData derived from interviewer-administered questionnaires were used for multivariable generalized linear mixed-effects multiple regression (GLMM) analyses.ResultsAmong 1,348 PWUD, 469 (34.8%) reported barriers to accessing health services at least once during the study period. The median average pain severity was 3 (IQR: 0-6) out of 10. A dose-response relationship was observed between greater pain and increased odds of reporting barriers to accessing health services (adjusted odds ratio [AOR]: 1.59, 95% confidence interval [CI]: 1.15-2.21, p = .005 for mild versus no pain; AOR: 1.76, 95% CI: 1.30-2.37, p < .001 for moderate versus no pain; AOR: 2.55, 95% CI: 1.92-3.37, p < .001 for severe versus no pain). Common barriers included poor treatment by health professionals, socio-structural barriers such as transportation or mobility, and long wait lists or wait times.ConclusionsPain may be a significant risk factor associated with increased barriers to accessing health services among PWUD. Attention to pain management may improve access to health services, and reducing barriers to health services may conversely improve pain management and its related risks and harms.Copyright © 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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