A scoping review of psychiatric conditions associated with chronic pain in the homeless and marginally housed population.

Researchers conducted a comprehensive review to understand how chronic pain and mental health conditions affect homeless individuals, a population that faces unique healthcare challenges. They searched multiple medical databases and examined 57 studies, most conducted in the United States. The review found that homeless people with chronic pain face numerous interconnected obstacles that make their situation worse. Many turn to drugs as a way to cope with pain, while others developed pain problems after opioid use. Mental health conditions like post-traumatic stress disorder (PTSD), depression, and anxiety were commonly found alongside chronic pain, creating a cycle that intensifies suffering. Other barriers included financial difficulties, transportation problems to access care, and stigma from healthcare providers. Importantly, the researchers identified several approaches that helped manage pain in this population. Acupuncture emerged as one of the beneficial pain management strategies, alongside cannabis use and a trauma therapy called Accelerated Resolution Therapy. This is significant because homeless individuals need accessible, non-pharmaceutical options for pain relief. The review highlights that acupuncture may offer a valuable treatment approach for people experiencing both chronic pain and mental health challenges, particularly those facing housing instability. The combination of chronic pain and psychiatric conditions creates especially difficult circumstances for homeless individuals, but acupuncture represents a potentially helpful intervention. If you're considering acupuncture for chronic pain, especially if you're also dealing with mental health concerns, consult with a licensed acupuncturist experienced in treating complex conditions.

This scoping review examined the intersection of chronic pain and psychiatric comorbidities in homeless populations. Researchers systematically searched MEDLINE, EMBASE, PsycINFO, Web of Science, and grey literature, identifying 57 studies predominantly from the United States. Quality appraisal utilized the PHO MetaQAT tool. Key findings revealed multiple exacerbating factors including substance use as pain self-medication, opioid use preceding pain onset, financial barriers, transportation challenges, healthcare stigma, and high prevalence of PTSD, depression, and anxiety. The review identified acupuncture as one of three evidence-supported pain management strategies for this population, alongside cannabis and Accelerated Resolution Therapy for trauma. Clinical implications highlight the complex interplay between psychiatric conditions and pain perception, which intensifies adverse health outcomes in homeless individuals. Practitioners should recognize that homeless patients with chronic pain likely present with multiple comorbidities requiring integrated, trauma-informed care approaches. Acupuncture offers a non-pharmaceutical intervention suitable for this vulnerable population facing significant access barriers to conventional pain management.