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Pain as a risk factor for substance use: a qualitative study of people who use drugs in British Columbia, Canada

BACKGROUND: People who use drugs have a significantly higher prevalence of chronic non-cancer pain compared to the general population, yet little is known about how various policy, economic, physical, and social environments may serve as risk or protective factors in the context of concurrent pain a...

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Autores principales: Voon, Pauline, Greer, Alissa M., Amlani, Ashraf, Newman, Cheri, Burmeister, Charlene, Buxton, Jane A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034304/
https://www.ncbi.nlm.nih.gov/pubmed/29976203
http://dx.doi.org/10.1186/s12954-018-0241-y
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author Voon, Pauline
Greer, Alissa M.
Amlani, Ashraf
Newman, Cheri
Burmeister, Charlene
Buxton, Jane A.
author_facet Voon, Pauline
Greer, Alissa M.
Amlani, Ashraf
Newman, Cheri
Burmeister, Charlene
Buxton, Jane A.
author_sort Voon, Pauline
collection PubMed
description BACKGROUND: People who use drugs have a significantly higher prevalence of chronic non-cancer pain compared to the general population, yet little is known about how various policy, economic, physical, and social environments may serve as risk or protective factors in the context of concurrent pain and substance use. Therefore, this study sought to explore perspectives, risks, and harms associated with pain among people who use drugs. METHODS: Thirteen focus group interviews were held across British Columbia, Canada, from July to September 2015. In total, 83 people who had lived experience with substance use participated in the study. Using an interpretive description approach, themes were conceptualized according to the Rhodes’ Risk Environment and patient-centered care frameworks. RESULTS: Participants described how their experiences with inadequately managed pain in various policy, economic, physical, and social environments reinforced marginalization, such as restrictive policies, economic vulnerability, lack of access to socio-physical support systems, stigma from health professionals, and denial of pain medication leading to risky self-medication. Principles of patient-centered care were often not upheld, from a lack of recognition of patients as experts in understanding their unique pain needs and experiences, to an absence of shared power and decision-making, which often resulted in distrust of the patient-provider relationship. CONCLUSIONS: Various risk environments and non-patient-centered interactions may contribute to an array of health and social harms in the context of inadequately managed pain among people who use drugs.
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spelling pubmed-60343042018-07-09 Pain as a risk factor for substance use: a qualitative study of people who use drugs in British Columbia, Canada Voon, Pauline Greer, Alissa M. Amlani, Ashraf Newman, Cheri Burmeister, Charlene Buxton, Jane A. Harm Reduct J Research BACKGROUND: People who use drugs have a significantly higher prevalence of chronic non-cancer pain compared to the general population, yet little is known about how various policy, economic, physical, and social environments may serve as risk or protective factors in the context of concurrent pain and substance use. Therefore, this study sought to explore perspectives, risks, and harms associated with pain among people who use drugs. METHODS: Thirteen focus group interviews were held across British Columbia, Canada, from July to September 2015. In total, 83 people who had lived experience with substance use participated in the study. Using an interpretive description approach, themes were conceptualized according to the Rhodes’ Risk Environment and patient-centered care frameworks. RESULTS: Participants described how their experiences with inadequately managed pain in various policy, economic, physical, and social environments reinforced marginalization, such as restrictive policies, economic vulnerability, lack of access to socio-physical support systems, stigma from health professionals, and denial of pain medication leading to risky self-medication. Principles of patient-centered care were often not upheld, from a lack of recognition of patients as experts in understanding their unique pain needs and experiences, to an absence of shared power and decision-making, which often resulted in distrust of the patient-provider relationship. CONCLUSIONS: Various risk environments and non-patient-centered interactions may contribute to an array of health and social harms in the context of inadequately managed pain among people who use drugs. BioMed Central 2018-07-05 /pmc/articles/PMC6034304/ /pubmed/29976203 http://dx.doi.org/10.1186/s12954-018-0241-y Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Voon, Pauline
Greer, Alissa M.
Amlani, Ashraf
Newman, Cheri
Burmeister, Charlene
Buxton, Jane A.
Pain as a risk factor for substance use: a qualitative study of people who use drugs in British Columbia, Canada
title Pain as a risk factor for substance use: a qualitative study of people who use drugs in British Columbia, Canada
title_full Pain as a risk factor for substance use: a qualitative study of people who use drugs in British Columbia, Canada
title_fullStr Pain as a risk factor for substance use: a qualitative study of people who use drugs in British Columbia, Canada
title_full_unstemmed Pain as a risk factor for substance use: a qualitative study of people who use drugs in British Columbia, Canada
title_short Pain as a risk factor for substance use: a qualitative study of people who use drugs in British Columbia, Canada
title_sort pain as a risk factor for substance use: a qualitative study of people who use drugs in british columbia, canada
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034304/
https://www.ncbi.nlm.nih.gov/pubmed/29976203
http://dx.doi.org/10.1186/s12954-018-0241-y
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