title: Prevalence and experience of chronic pain in suburban drug injectors.
abstract: OBJECTIVE
  To explore the relationship between chronic pain and characteristics, behaviors, and psychological status of suburban Connecticut injection drug users.
  
  
  METHODS
  Cross-sectional study with quantitative interview and serological testing for HIV and hepatitis B and C in 456 individuals who injected drugs in the past month. Participants were dichotomized into those reporting current chronic pain of at least six months duration and all others. The interview covered (i) sociodemographics, (ii) injection drug use, (iii) interactions with drug treatment, criminal justice, and harm reduction, (iv) screening for alcohol use, chronic pain, anxiety, and depression, and (v) knowledge regarding HIV, hepatitis B (HBV) and C (HCV), and opioid overdose. Serological testing for HIV, HBV, and HCV was conducted.
  
  
  RESULTS
  One-third (n = 143) reported chronic pain. These individuals differed significantly from those not reporting chronic pain on characteristics that included older age, lower educational achievement, and injection of pharmaceutical opioids. They also reported experiencing more psychological and family problems on the ASI and higher levels of depression and anxiety. Four of five individuals with chronic pain (n = 117) reported non-medical opioid use prior to the onset of chronic pain.
  
  
  CONCLUSIONS
  Chronic pain is common among drug injectors in our study population although it was unusual for chronic pain to have preceded non-medical opioid use. Psychological problems in injectors with co-occurring chronic pain are likely pose significant complications to successful treatment for substance abuse, pain, or infectious disease treatment.
authors.affiliation: Center for Interdisciplinary Research on AIDS and the Department of Epidemiology of Microbial Disease, Yale University School of Public Health, 60 College Street, New Haven, CT 06520, United States. Electronic address: robert.heimer@yale.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Heimer
authors.affiliation: Center for Interdisciplinary Research on AIDS and the Department of Epidemiology of Microbial Disease, Yale University School of Public Health, 60 College Street, New Haven, CT 06520, United States.
authors.forename: Weihai
authors.initials: W
authors.lastname: Zhan
authors.affiliation: Center for Interdisciplinary Research on AIDS and the Department of Epidemiology of Microbial Disease, Yale University School of Public Health, 60 College Street, New Haven, CT 06520, United States.
authors.forename: Lauretta E
authors.initials: LE
authors.lastname: Grau
mesh_terms: D000328:Adult; D000367:Age Factors; D000701:Analgesics, Opioid / Q000627:therapeutic use; D059350:Chronic Pain / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D003237:Connecticut / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000150:complications / Q000523:psychology; D058748:Pain Perception; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000523:psychology*; D013383:Suburban Population
chemical_list: D000701:Analgesics, Opioid; D009294:Narcotics
keywords: Anxiety; Chronic pain; Depression; Injection drug use; Opioids; Suburbs
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