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

Participants reported their own pain and access barriers, so answers could be affected by recall or by wanting to present themselves favourably. The barrier outcome included people who did not try to access services and people who accessed services without barriers, so it could not show whether pain changed actual need for or uptake of services. The analysis did not separate acute pain from chronic pain. The violence covariate combined being attacked or assaulted with being an instigator of violence. The study found associations, not cause and effect. It was conducted in Vancouver where no-cost medical care and harm-reduction primary care were available, so results may not apply to places without that access. The sample was predominantly middle-aged white males, although 35.5% were First Nations, Aboriginal, Inuit, or Métis. Thirty-eight observations were excluded because responses to the primary pain or barrier variables were missing.

Do not read this as proof that treating pain will reduce access barriers. The study measured associations in people who use drugs and did not determine causal pathways or test a nursing intervention.