268393 Prevalence of physical pain and associated mental health and prescription drug abuse among injection drug users in San Francisco

Tuesday, October 30, 2012

Scott Novak, PhD , Behavioral Epidemiology, RTI International, Research Triangle Park, NC
Lynn Wenger, MSW, MPH , Urban Health Program, RTI International, San Francisco, CA
Alex H. Kral, PhD , Urban Health Program, RTI International, San Francisco, CA
Mark Edlund, MD, PhD , Behavioral Epidemiology, RTI International, Research Triangle Park, NC
Little information exists on the daily experiences of pain among street-level injection drug users. The data reported herein are drawn from an ongoing community-based survey among street-level injection drug users in San Francisco. To date, 143 clinical assessments have been conducted, with sample characteristics as follows: 76% male, median age 35 (sd 14.5 years), and 39% white. Over 56% of the sample reported any physical pain in prior day. The overall pain rating (0-10) was in the moderate range (mean=5.4, sd=2.5). The levels of pain over the day were quite variable, ranging from 7.3 (range 0-10, sd=2.3) at its worst to 2.98 (sd=2.5) at its least. No significant differences were observed in non-medical prescription pain reliever use in the past 6 months (59% among those with pain versus 58% among those with no pain). However, those with current pain had more extensive histories of nonmedical opioid use, using on average of 87 days in the prior 6 months compared to 51 days for those with no pain (p<.001), greater use of more potent Schedule II opioids, and were less likely to tamper as a means of ingestion. High levels of physical pain were associated with greater mental health problems. No differences in health care utilization were observed between those with and without pain, indicating high rates of undertreatment. About 12% of the sample was HIV positive, though not associated with pain. The success of public health interventions must consider the role of pain given its prominence in this community.

Learning Areas:
Assessment of individual and community needs for health education
Clinical medicine applied in public health
Planning of health education strategies, interventions, and programs
Public health or related education
Public health or related research

Learning Objectives:
1) Identify how levels of pain vary over the course of a 24 period in this high-risk population 2) Identify the sources of pain and levels of impairment 3) Differentiate differences in prescription drug use, mental health, and health care utilization between those with and without current pain.

Keywords: Mental Illness, Prescription Drug Use Patterns

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator on the research presented in this talk. I am the PI or Co-I on over 20 NIH, CDC, and SAMHSA projects funded to examine mental illness and substance abuse. I have also testified before the FDA on prescription drug abuse and serve on the editorial boards of the Journal of Consulting and Clinical Pscyhology and Health Psychology. I also have 50 plus publications and over 100 presentations at professional meetings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.