Evidence map›Paper›PMID 42321749›Full record

ArticleHarm reduction journal2026

Pain is associated with reduced adherence to safer injection practices among people who inject opioids.

O Trent Hall, John A Sturgeon, Jasmin Bradley, Abigail Helm, Johnathan Rausch, Emma Kuloszewski, Megan Deaner, Carlos Malvestutto, Ashley Lipps, Afton Hassett

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Article in Harm reduction journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

O Trent HallDepartment of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA. Orman.Hall@osumc.edu.
John A SturgeonDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Jasmin BradleySafe Point Harm Reduction Program, Equitas Health, Columbus, OH, USA.
Abigail HelmDepartment of Medicine, Division of Health Systems Science, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Johnathan RauschOhio University Heritage College of Osteopathic Medicine Dublin Campus, Columbus, OH, USA.
Emma KuloszewskiDepartment of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA.
Megan DeanerDepartment of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA.
Carlos MalvestuttoDivision of Infectious Diseases Columbus, Ohio State University College of Medicine, Columbus, OH, USA.
Ashley LippsDivision of Infectious Diseases Columbus, Ohio State University College of Medicine, Columbus, OH, USA.
Afton HassettDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInjection opioid use is associated with fatal and non-fatal harms including accidental overdose and infectious diseases. Syringe service programs offer sterile injection equipment and safer injection training to reduce the incidence of injection-related harms. Nevertheless, factors that might reduce adherence to safer injection practices are understudied. This report explores pain as one such factor.

methodsPeople who inject opioids (n = 130) were recruited from a syringe service program for a cross-sectional survey assessing the relationship between fluctuations in pain severity and adherence to safer injection practices over the past 7 days.

resultsA within-subjects Sign Test analysis revealed participants' adherence to safer injection practices fluctuated with changes in pain severity. When their pain was at its worst, participants reported they less often engaged in hand washing (Z -5.63, P < .001), cleaning the injection site (Z -5.29, P  < .001), and waiting until in a clean safe place to inject (Z -3.94, P < .001). Additionally, they more often reused their own injection equipment (Z -2.55, P = .011), and injected faster, or at a higher dose (Z -2.71, P = .007) when in worse pain.

conclusionsThis study provides initial evidence that pain is associated with reduced adherence to safer injection practices among people who inject opioids. Although all study participants received training in safer injection practices and cost-free sterile injection equipment, within-subject adherence to safer use practices varied significantly under conditions of best and worst pain.

Indexed as

Analgesics, OpioidPainPatient ComplianceSubstance Abuse, IntravenousAdultCross-Sectional StudiesFemaleHarm ReductionHumansInjections, IntravenousMaleMiddle AgedNeedle-Exchange ProgramsAnalgesics, OpioidHarm reductionNeedle-exchange programsOpioid-related disordersPainRisk behaviorsSafer injection practices

Identifiers

PMID42321749
PMCPMC13531960

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.