ArticleSocial science & medicine (1982)2020
Normalised pain and severe health care delay among people who inject drugs in London: Adapting cultural safety principles to promote care.
Article in Social science & medicine (1982), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
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Who cites it
37 citing papers in PubMed, 83 citations in OpenAlex.
- Improving opioid substitution therapy in the acute hospital setting: implementation of a best practice guideline.BMJ open quality · 2026Article
- Building and Boosting Capitals for Health Care Access: A Qualitative Study of Homeless Health Peer Advocacy in London, UK.Sociology of health & illness · 2026Article
- Healthcare access and perceived value of liver screening among people experiencing homelessness and substance use disorders: a qualitative study.BMC health services research · 2025Article
- Peer-Delivered Hepatitis C Testing and Health Screening Provided in a Community Pharmacy Setting: Proof of Concept.Pharmacy (Basel, Switzerland) · 2025Article
- Experiences of stigma and discrimination among people experiencing homelessness: a cross-sectional pilot survey in South London, UK.BMJ open · 2025Article
- Rising transphobia and disparities in drug-related harm experienced by transgender and gender-diverse people.Harm reduction journal · 2025Review
- Exploring the value and acceptability of a patient navigator program for people who inject drugs and are hospitalized for bacterial infections: patients', community organization and healthcare workers' perspectives.BMC infectious diseases · 2025Article
- Interventions to improve access to opioid agonist therapy in acute hospitals: A scoping review.PLOS mental health · 2025Article
- "It always needs a higher level of care than what I can provide": Practical, ethical, and administrative tensions arising from the integration of wound care services into syringe service programs in Maryland.The International journal on drug policy · 2025Article
- Improving hospital care for people who use drugs: deliberative process development of a clinical guideline for opioid withdrawal management.Harm reduction journal · 2024Article
- Social determinants of injection drug use-associated bacterial infections and treatment outcomes: systematic review and meta-analysis.medRxiv : the preprint server for health sciences · 2024Article
- Diagnosis and management of tuberculosis infection in inclusion health populations in London.BMC infectious diseases · 2024Article
- Improving hospital-based opioid substitution therapy (iHOST): protocol for a mixed-methods evaluation.NIHR open research · 2024Article
- Managing Opioid Withdrawal Symptoms During the Fentanyl Crisis: A Review.Substance abuse and rehabilitation · 2024Review
- Development, acceptability and feasibility of a personalised, behavioural intervention to prevent bacterial skin and soft tissue infections among people who inject drugs: a mixed-methods Person-Based Approach study.Harm reduction journal · 2023Article
- Analysis of the UK Government's 10-Year Drugs Strategy-a resource for practitioners and policymakers.Journal of public health (Oxford, England) · 2023Article
- Article
- Safety and preliminary outcomes of short-acting opioid agonist treatment (sOAT) for hospitalized patients with opioid use disorder.Addiction science & clinical practice · 2023Article
- Article
- A scoping review of psychiatric conditions associated with chronic pain in the homeless and marginally housed population.Frontiers in pain research (Lausanne, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In the United Kingdom, increases in premature mortality among the intersecting populations of people made homeless and people who inject drugs map onto the implementation and solidification of fiscal austerity policies over the past decade, rather than drug market fluctuations and trends as in North America. In this context, it is crucial to explore how poverty, multi-morbidity and care delay interplay in exacerbating vulnerability to mortality among an aging population of people who use illicit drugs. The mixed methods Care & Prevent study generated survey data with 455 PWID and in-depth qualitative interviews with a subsample (n = 36). Participants were recruited though drug treatment services and homeless hostels in London from October 2017-June 2019. This paper focuses on qualitative findings, analysed thematically and contextualised in relation to the broader survey sample. Survey participants report an extensive history of rough sleeping (78%); injecting-related bacterial infections (65%) and related hospitalisation (30%). Qualitative accounts emphasise engagement with the medical system as a 'last resort', with admission to hospital in a critical or a "near death" condition common. For many severe physical pain and debility were normalised, incorporated into the day to day. In a context of everyday violence and marginalisation, avoidance of medical care can have a protective impetus. Translation of cultural safety principles to care for people who inject drugs in hospital settings offers transformative potential to reduce serious health harms among this population.
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