title: Self-management of pain among people who inject drugs in Vancouver.
abstract: OBJECTIVE
  To evaluate factors and methods associated with self-management of pain among people who inject drugs (IDUs) in Vancouver (Canada).
  
  
  METHODS
  This cross-sectional study used bivariate statistics and multivariate logistic regression to analyze self-reported responses among 483 IDUs reporting moderate-to-extreme pain in two prospective cohort studies from 1 December 2012 to 31 May 2013.
  
  
  RESULTS
  Median age was 49.6 years (interquartile range: 43.9-54.6 years), 33.1% of IDUs were female and 97.5% reported self-management of pain. Variables independently and positively associated with self-managed pain included having been refused a prescription for pain medication (adjusted odds ratio: 7.83; 95% CI: 1.64-37.3) and having ever been homeless (adjusted odds ratio: 3.70; 95% CI: 1.00-13.7). Common methods of self-management of pain included injecting heroin (52.7%) and obtaining diverted prescription pain medication from the street (65.0%).
  
  
  CONCLUSIONS
  Self-management of pain was common among IDUs who reported moderate-to-extreme pain in this setting, particularly among those who had been refused a prescription for pain medication and those who had ever been homeless. These data highlight the challenges of adequate pain management among IDUs.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
authors.forename: Pauline
authors.initials: P
authors.lastname: Voon
authors.forename: Cody
authors.initials: C
authors.lastname: Callon
authors.forename: Paul
authors.initials: P
authors.lastname: Nguyen
authors.forename: Sabina
authors.initials: S
authors.lastname: Dobrer
authors.forename: Julio
authors.initials: J
authors.lastname: Montaner
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000328:Adult; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications; D059408:Pain Management; D012648:Self Care; D015819:Substance Abuse, Intravenous / Q000150:complications*