Chronic Pain: Initial Findings From a Cohort of People Who Inject Drugs in Montreal, Canada

Author: Sasha Udhesister Stine Hoj Nanor Minoyan Didier Jutras-Aswad Valérie Martel-Laferrière Gabrielle Pagé Sarah Larney Julie Bruneau

Theme: Epidemiology & Public Health Research Year: 2022

People who inject drugs (PWID) are disproportionally affected by synergistic opioid, overdose, and
blood-borne virus epidemics. Estimates suggest up to 50% of PWID live with chronic pain, a condition
associated with functional impairment and mental distress. Little is known about the chronic pain
experience among PWID, including how it relates to drug use patterns and related harms such as HCV
infection. We aimed to characterize chronic pain in a community-based sample of PWID.
Participants of a community-based cohort study of PWID in Montreal were followed at 3-month
intervals for up to 5 years. We used baseline data collected from this community-based cohort from
2017-2022. Using the Brief Pain Inventory scale, we collected data on the prevalence of chronic pain
(defined as intermittent or continuous pain lasting more than three months) and the reported cause and
site of the chronic pain.
We sampled 543 participants with a median age of 45 years, and 13.7% were women. 36.6% of
participants injected cocaine and 23.6% of participants injected heroin, both within the past 3 months.
Chronic pain was reported by 46% (n=252) of participants and was higher among men (n= 215; 47%) and
participants over the age of 40 (n= 174; 50%). The leading cause of chronic pain was accidents (n= 96;
38%). The most common sites of pain were lower limbs and lower back, reported by 31 % (n=77) and
24% of participants, respectively.
Chronic pain is common in this cohort of people who inject drugs and more frequently affects men and
older participants and is linked primarily to prior accidents. These results indicate the need to further
characterize and understand the chronic pain experience among PWID, and to investigate associations
between chronic pain and substance use, sex and gender, and drug-related harms, including HCV
incidence and overdoses.
Disclosure of Interest:

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