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Population Health Policy Advocacy
Kyla Hoag
NURS-FPX6026: Biopsychosocial Concepts for Advanced Nursing Practice 2
Capella University
Kathryn Sheppard
December 10, 2022
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Population Health Policy Advocacy
Current State of Quality of Care for the Homeless Population
I am writing to address the negative correlation between chronic pain and drug addiction
among the homeless population. The rates of opioid abuse and addiction among the homeless
population are much higher than the public population. The presence of chronic pain in
combination with the stressors of being homeless is likely to lead to opioid misuse or addiction.
“Chronic pain is thought to be common among homeless people, in part due to frequent injuries
and the high prevalence of concurrent health conditions” (Hwang et. al., 2011, p. 1). The
homeless population often self-medicates with street drugs, and they use substances to numb the
pain and stressors that comes with living on the street. Being homeless also causes a lack of
stability, smaller support networks, and they typically do not have easy access to traditional
recovery programs, detox centers, and rehab programs.
The Necessity of a Systematic Change
It is crucial to look for a solution that will allow the homeless population to effectively
manage their chronic pain and mental health issues, and to get them most importantly into a safe
environment, where they do not have access to substances to continue feeding their addiction.
For some patients dealing with chronic pain, over the counter pain relievers and other methods
are ineffective, therefore, they are prescribed opioid medications. For patients who are prescribed
opioids for chronic pain, there needs to be screening tools and other precautions put in place by
the doctor’s office to prevent possible substance abuse. However, for some patients, prescribing
opioids for their chronic pain may be too unsafe and other options should be considered. By
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incorporating a multidisciplinary approach to pain management, patients might be able to find
adequate pain relief without the harmful risks of opioids.
Improving the Quality of Care in the Homeless Population
The proposed policy I will be discussing is an interdisciplinary pain rehabilitation
program. The interdisciplinary approach to institutional and community problems occurs when
members of different disciplines work inter-dependently (as opposed to the term “multi-
disciplinary,” which describes members of different disciplines who function independently”
(Hamel, 2001, p. 58). An interdisciplinary program is necessary for this population because they
face a variety of issues that make traditional drug rehabilitation programs less efficient. An
interdisciplinary program addresses the contributors to chronic pain which include behavioral,
psychological, and physical aspects. “An individual’s underlying biological, psychological,
cognitive, and social characteristics interact in a complex way and in combination with both the
situation and the environment, producing the individual’s pain experience” (Eucker et. al., 2022,
p. 2).
“To effectively serve the homeless population, rehab programs must do at least three
things: provide services that address the needs for employment, income, and housing; offer
access to affordable interventions; and provide long-term care, treatment, and support” (Smith,
2020). The most effective rehab programs for the homeless population understand that substance
abuse cannot be managed without addressing the needs of the person as a whole. An
interdisciplinary pain rehabilitation program can help these patients lessen drug use, increase
psychological functioning, promote healthy behaviors, and have a safe place to call home,
temporarily.
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Interprofessional Aspects of the Policy
Effective rehab programs for the homeless population should provide patient-centered
services that are multidisciplinary, meaning competent enough to treat various conditions and
coordinate further services. Chronic pain is important to get under control, but most importantly,
the homeless population’s primary concern that needs to be addressed is housing. Once basic
needs are met, problems with addicted can be focused on. An interprofessional team should be
established to help develop this type of patient’s plan of care. Offering health care services to the
homeless community requires several health care authorities to meet the unpredictable needs of
the community. This team should include: a primary care provider, a pain specialist, nurses, a
mental health professional such as a therapist or psychiatrist, and social services.
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References
Eucker, Knisely, M. R., & Simon, C. (2022). Nonopioid Treatments for Chronic Pain—
Integrating Multimodal Biopsychosocial Approaches to Pain Management. JAMA
Network Open., 5(6), e2216482–e2216482.
https://doi.org/10.1001/jamanetworkopen.2022.16482
Hwang S., Wilkins E., Chambers C., Estrabillo E., Berends J., MacDonald A. (2011). Chronic
pain among homeless persons: Characteristics, treatment, and barriers to management.
BMC Fam Pract. 12(73), 2-9. https://doi.org/10.1186/1471-2296-12-73
Smith, Johnelle. (2020). Drug And alcohol rehab programs for homeless individuals. Addiction
Resources. Retrieved from
https://www.addictionresource.net/treatment/inpatient/homeless-
individuals/#homelessness-and-addiction
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Journal Guidelines
The journal I chose to use for this assignment is the Journal of Psychosocial Nursing and Mental
Health Services. The letter must be submitted within 12 months of the article’s
publication to be considered for possible publication and letters should be longer than
500 words. References should be kept to a maximum of three.
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