Increasing Equity in Pain Management, Substance Use Disorder Treatment, and Linkages to CARE

PATIENT PERSONA: Diana

Diana is a 57-year-old divorced woman of Mexican descent who works as a floating lab tech for a large healthcare system in the Midwestern U.S. Diana provides financial support to her 80-year-old mother and helps to watch her 3 grandchildren on the weekends. For work, Diana commutes to multiple labs across the city. Diana has long wanted to return to school to become a nurse, but cost and time constraints have prevented her from doing so. In addition, Diana lives with chronic pain from fibromyalgia, degenerative joint disease of the neck and spine, and moderate arthritis in her right hip and bilateral knees. Her arthritis frequently flares up when she works more than 8 hours a day. To reduce her symptoms, Diana eats healthy food and uses integrative health practices, such as group acupuncture and yoga, both of which she accesses at the local community center. Despite these efforts, Diana’s pain prevents her from sleeping well at night. She has found that taking high-dose hemp-based cannabidiol with a single tablet of hydrocodone-acetaminophen can minimize her pain enough to improve sleep. Her primary care provider, however, will not prescribe hydrocodone-acetaminophen for long-term use. Because of sleep deprivation due to untreated chronic pain, Diana has been making mistakes at work. She now worries she will lose her job.

Reflections and questions

■ How does Diana’s persona represent a unique, yet also universal story of the intersection of pain, substance use, and social and health inequities? ■ As you navigate through this Resource Guide, think about Diana’s story and ask yourself how the information and resources presented here could help address Diana’s needs.

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