| Living with and managing pain
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Poor weather conditions increase pain level, specifically for participants with arthritis Poor sleeping conditions exacerbate suffering caused by pain such as sleeping on streets, in shelters, or in vehicles Grogginess caused by pain medications is a challenging side effect because of lack of safety living on streets (‘I need to keep my wits about me to protect myself’) Self-medicating with marijuana or other illegal substances to alleviate pain and promote a restless sleep Lack of treatment options result in homeless people developing a high tolerance for pain (‘I guess you get used to it’) Health problems, many associated with pain, begin with or are intensified by homelessness (‘Most people I know did not have pain before they came to the shelter, at the shelter they come down with a lot of stuff.’) Participants fear of becoming addicted to pain medication (i.e., methadone, morphine) |
| Accessing quality treatment
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Lack of health insurance and primary care provider contributes to high use of urgent care centers It can take many months to locate and get an appointment with a health care provider who will accept medical coupons (‘Doctors are overloaded’) Discriminatory and poor treatment of homeless by health care providers and staff at local urgent care centers due to status of clients (i.e., homeless, poor physical appearance, and lack of insurance). Participants stated that they were not taken seriously, not trusted, not listened to, and not provided a proper diagnosis (“... being homeless, doctors don’t care. If I had job and a place, insurance—they would be going out of their way to take care of me”) Assumption on behalf of health care providers that all homeless are drug-seeking (“... if you are homeless they automatically think you are a drug addict”) Common treatment at local urgent care centers is to provide ibuprofen Health care providers’ liability and concern of overmedicating or contributing to drug-seeking behaviors inhibits proper treatment (“Doctors are constrained to give out meds because they might get in trouble”) |
