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,


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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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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.

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.

Smith, Johnelle. (2020). Drug And alcohol rehab programs for homeless individuals. Addiction

Resources. Retrieved from


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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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