scholarly journals Perspectives on Pain, Engagement in HIV Care, and Behavioral Interventions for Chronic Pain Among Older Sexual Minority Men Living with HIV and Chronic Pain: A Qualitative Analysis

Pain Medicine ◽  
2020 ◽  
Author(s):  
Samantha M McKetchnie ◽  
Corinne Beaugard ◽  
S Wade Taylor ◽  
Conall O’Cleirigh
Keyword(s):  
Chronic Pain ◽  
Substance Use ◽  
Hiv Care ◽  
Sexual Minority Men ◽  
Problematic Substance Use ◽  
Problematic Substance ◽  
Minority Men ◽  
Engagement In Hiv Care ◽  
Living With Hiv ◽  
The Impact

Abstract Objective and Methods The transition of HIV from an acute, fatal illness to a chronic health condition has shifted the treatment needs of people living with HIV (PLWH). PLWH, including sexual minority men (SMM), are living longer and are subject to health concerns often associated with aging. A major health concern of older SMM living with HIV who report problematic substance use is chronic pain. This qualitative analysis of 15 one-on-one interviews with older SMM living with HIV and chronic pain aimed to characterize this population’s experiences with pain, engagement in HIV care, and problematic substance use. This study was conducted in a community health center in Boston, MA. We also solicited suggestions for preferred intervention strategies. Results Three main themes emerged from the interview transcripts: 1) the impact of chronic pain and pain treatment on engagement in HIV clinical care; 2) the impact of substance use on chronic pain; and 3) response to interventions to address chronic pain and substance use. Conclusions These findings underscore the need for interventions that address the structural, physical, and psychological barriers to engagement in medical and self-care that affect older SMM living with HIV and chronic pain.

scholarly journals Patients' perceptions of the pathways linking chronic pain with problematic substance use

Pain ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jessica J. Wyse ◽  
Jennette Lovejoy ◽  
Julia Holloway ◽  
Benjamin J. Morasco ◽  
Steven K. Dobscha ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Substance Use ◽  
Problematic Substance Use ◽  
Problematic Substance

scholarly journals P008: Addressing chronic pain and problematic substance use of opioids in the emergency department: can a comprehensive framework for care work?

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S81-S81
Author(s):  
M.A. Allen
Keyword(s):  
Emergency Department ◽  
Chronic Pain ◽  
Substance Use ◽  
Best Practice ◽  
Electronic Record ◽  
Emergency Department Visits ◽  
Direct Result ◽  
Complex Needs ◽  
Problematic Substance Use ◽  
Problematic Substance

Introduction: Chronic pain and substance misuse are complex chronic illness that are subject to prejudice, misinterpretation and cultural biases. They require a broad, multi-disciplined approach if they are to be effectively managed. Barrier’s to effective care in the emergency department include our reliance on pain scales alone to effectively triage and manage chronic pain, differing philosophy’s and attitudes regarding the appropriate use of high risk pain pharmacology including opioids and confusing classifications systems used to describe pain and problematic substance use which can often lead to further stigmatization and over medicating. Methods: The charts of thirteen patients with complex pain and problematic substance use who had more than 360 visits to a regional emergency department in one year were reviewed retrospectively and data collected regarding frequency of visits and disposition after the implementation of a comprehensive pain and addiction strategy from April 2011 to August 2015. Results: In the first year of implementation there was a 70% drop in the frequency of emergency department visits. Five patients (38%) required a comprehensive pain plan. Six agreed (46%) to a direct referral to our mental health, addiction and chronic pain services. Two patients (15%) were lost to follow-up. Review of the electronic record to track patient visits to provincial emergency departments did not show an increase in visits to other facilities within the province. Review of visits in 2015 show a 97% drop in the frequency of visits. Family Physicians in the community did not report an increase in the frequency of patient visits as a direct result of the implementation of this strategy nor was there an increase in complaints to administration regarding ineffective pain management. Conclusion: Although survey numbers are low it suggests that a framework for the management of complex pain and substance use disorders can be successfully implemented in the emergency department improving timely access to appropriate management and resources for patients based on best practice to address their complex needs.

Substance Use and Motivational Interviewing

2019 ◽  
pp. 105-114 ◽  
Author(s):  
Liu yi Lin ◽  
Linda R. Frank ◽  
Antoine Douaihy
Keyword(s):  
Substance Use ◽  
Motivational Interviewing ◽  
Substance Use Disorder ◽  
Integrated Approach ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Co Morbidity ◽  
Important Health ◽  
Living With Hiv ◽  
The Impact

People living with HIV (PLWH) who use drugs and alcohol are particularly likely to experience gaps across the HIV care continuum. People with co-occurring HIV and a substance use disorder face significant challenges in treatment. Substance use is well-known to be linked to important health behaviors and outcomes including adherence to antiretroviral and treatment, immunosuppression, and sexual risk behaviors. This chapter provides a review of the impact of substance use in PLWH and the role of motivational interviewing as part of an integrated approach to care of PLWH with co-occurring substance use disorders. The chapter concludes with a case example to illustrate the role that motivational interviewing can play the care of PLWH with a co-morbidity of substance use disorder.

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