Chronic pain in homeless people not managed well: study
July 21, 2011 in HealthChronic pain is not managed well in the general population and it's an even greater challenge for homeless people, according to new research by St. Michael's Hospital.
Twenty-five per cent of Canadians say they have continuous or intermittent chronic pain lasting six months or more. The number is likely to be even higher among homeless people, in part due to frequent injuries.
Of the 152 residents of homeless shelters with chronic pain studied by Dr. Stephen Hwang, more than one-third (37 per cent) had Chronic Pain Grade IV, the highest level, indicating high intensity and high disability.
Almost half the participants (46 per cent) reported using street drugs to treat their pain and 29 per cent used alcohol, said Dr. Hwang, a physician and researcher with the hospital's Centre for Research on Inner City Health.
Only half (51 per cent) of the participants were being treated for their pain by a physician. More than three-quarters (77 per cent) of the physicians said they had difficulty managing the patients' pain because of such things as a history of addiction, mental illness and missed appointments.
The research results were published in the online journal BMC Family Practice. Dr. Hwang said he believes it's the first study in a peer-reviewed journal to describe the severity and management of chronic pain among residents of homeless shelters.
"Our study demonstrates the need for improved approaches to the management of chronic pain in the homeless population," he said.
He believes community outreach programs may be necessary to help homeless people with chronic pain find health care. As well, health care providers who work with marginalized populations need to familiarize themselves with their patients' housing situations and routinely screen individuals who are homeless for chronic pain.
"Clinicians should also inquire about barriers to pain management such as financial ability to obtain appropriate over-the-counter and prescription medications. The adverse effects of homeless people's living and sleeping conditions should also be considered."
Dr. Hwang said that while physicians may have justifiable concerns about prescribing opiod drugs to patients with a history of substance abuse, this should not be a reason to avoid addressing chronic pain management with them.
"The answer to pain is not always simply a pill," he said, noting studies that indicate opioids such as oxycontin are often over-prescribed.
"A lot of patients expect a pill, when often what they really need is physiotherapy, which they can't afford and isn't covered by insurance."
Homeless people said that from their viewpoint, the barriers to managing their pain included the stress of living in shelters, inability to afford prescription medications and poor sleeping conditions.
Provided by St. Michael's Hospital
-
Toronto homeless report barriers to health care
Jul 21, 2010 |
not rated yet |
0
-
Study: Patients often don't report pain
Feb 13, 2006 |
not rated yet |
0
-
No health card means no family doctor for many homeless people
May 24, 2011 |
not rated yet |
0
-
How best to treat chronic pain? The jury is still out
Jun 05, 2008 |
not rated yet |
0
-
Report: For every 1 homeless person in Canada, another 23 live in inadequate housing
Nov 19, 2010 |
not rated yet |
0
-
Of mice and mental models: Neuroscientific implications of risk-optimized behavior in the mouse
3 hours ago |
not rated yet |
0
-
Limits to growth: Scientists identify key metastasis-enabling enzyme
May 22, 2012 |
5 / 5 (3) |
0
-
Seeing is as seeing does: Spatially-structured retinal input in early development of cortical maps
Apr 26, 2012 |
5 / 5 (4) |
1
-
Dreamless nights: Brain activity during nonrapid eye movement sleep
Apr 09, 2012 |
4.4 / 5 (12) |
0
-
Take your time: Neurobiology sheds light on the superiority of spaced vs. massed learning
Mar 28, 2012 |
4.5 / 5 (21) |
3
-
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011
- More from Physics Forums - Independent Research
More news stories
In Spain, 70 percent of women use contraceptives during their first sexual encounter
Contraceptive use in Spain during the first sexual encounter is similar to other European countries. However, there are some geographical differences between Spanish regions: women in Murcia use contraceptives ...
Health
35 minutes ago |
not rated yet |
0
WHO target to cut early chronic illness deaths
The World Health Organization announced on Friday it was set to approve a new target to reduce premature deaths from chronic illnesses such as heart disease by a quarter by 2025.
Health
1 hour ago |
not rated yet |
0
Better response plans needed for children exposed to domestic violence
(Medical Xpress) -- Each year, millions of children are exposed to domestic violence, a traumatic experience that has been associated with cognitive, behavioral, social and emotional problems in childhood ...
Health
3 hours ago |
not rated yet |
0
Australia defiant on WTO cigarette challenge
Australia said Friday it would "vigorously defend" itself against complaints about its plan for plain cigarette packaging made by Honduras and Ukraine to the World Trade Organisation.
Health
3 hours ago |
5 / 5 (1) |
0
World 'no tobacco day' puts spotlight on dangers of smoking
Its not just smokers who are at-risk when it comes to tobacco smoke exposureand the health concerns of smoking cigarettes are not limited to the most known consequence: lung cancer.
Health
5 hours ago |
not rated yet |
0
Inherited DNA change explains overactive leukemia gene
A small inherited change in DNA is largely responsible for overactivating a gene linked to poor treatment response in people with acute leukemia.
Cancer may require simpler genetic mutations than previously thought
Chromosomal deletions in DNA often involve just one of two gene copies inherited from either parent. But scientists haven't known how a deletion in one gene from one parent, called a "hemizygous" deletion, can contribute ...
Implantable pain disk may help those with cancer
An estimated 3.5 million cancer patients around the globe are in severe pain from their disease, but many get no relief.
World Health Assembly endorses new plan to increase global access to vaccines
Ministers of Health from 194 countries at the Sixty-fifth World Health Assembly today endorsed a landmark Global Vaccine Action Plan (GVAP), a roadmap to prevent millions of deaths by 2020 through more equitable access to ...
Of mice and mental models: Neuroscientific implications of risk-optimized behavior in the mouse
(Medical Xpress) -- Regardless of an organism’s biological complexity, every encephalized animal continuously makes under-informed behavioral choices that can have serious consequences. Despite its ubiquity, ...
First study to suggest that the immune system may protect against Alzheimer's changes in humans
Recent work in mice suggested that the immune system is involved in removing beta-amyloid, the main Alzheimer's-causing substance in the brain. Researchers have now shown for the first time that this may apply in humans.