{"doi":"10.1093/pm/pnad150","title":"Pain in US corrections settings: the promise of digital solutions for better data and treatment access","abstract":"Estimates suggest that 50–100 million American adults live with ongoing pain—more than those affected by heart disease, diabetes, and cancer combined (see Table 1). Notably, these national prevalence estimates exclude the ∼5.5 million individuals incarcerated in jails and in state and United States (US) federal prisons, despite pain being common and impactful among individuals in corrections settings. Although pain prevalence literature is limited, some estimates suggest that up to 25% of individuals incarcerated in state and federal prisons have chronic pain. One study of 210 individuals in a county jail who were 55 years of age or older (of whom 60% were Black) revealed that 75% reported any current pain and 39% reported having frequent pain.1 Multimorbidity, the increased aging of the corrections population, social isolation, and insufficient pain treatment further contribute to chronic pain in corrections settings.1 Indeed, a Texas Department of Criminal Justice chronic cancer pain study (n = 102) found that 64% of individuals reported inadequate pain management.2 Taken together, individual small studies suggest that pain prevalence in corrections settings mirrors that in the general population. Notably, higher-quality and broad-scale data on pain are needed across corrections settings, as are solutions that expand access to effective pain care. Referenced Web links. Although the 2018 Federal Bureau of Prisons Clinical Guidance for pain treatment in corrections settings includes the biopsychosocial model of care, implementation of this model is fraught with many of the same barriers experienced nationally in non-corrections settings. Federal guidance recommends a multidimensional pain treatment approach that addresses biological, psychological, behavioral, familial, vocational, social, and medico-legal factors, with the goals of (1) improving patient function and (2) ensuring appropriate use of pain medication. Pain management implementation varies by clinician team size and involves either medical management teams (smaller facilities/capacity) or multidisciplinary pain management teams, which include a range of disciplines and can include outside specialist consultants who develop and implement comprehensive pain care plans that largely apply an interdisciplinary pain rehabilitation treatment approach as best practice. Interdisciplinary pain rehabilitation integrates into medical management team or pain management team physical reconditioning with pain education, mental health education, activity modification, and psychological and behavioral treatments. Clinical psychologists often deliver psychological interventions, including imagery and distraction, relaxation response training, cognitive behavioral therapy (CBT), acceptance and commitment therapy, biofeedback, and hypnotic analgesia, with specialized clinician training required for many of these. Though aspirational, interdisciplinary pain rehabilitation data for patient access and outcomes are lacking for corrections settings. Outside of corrections settings, national shortages in pain psychologists and poor access to pain psychology services have impeded the implementation of integrated pain treatment. Correction settings involve specific considerations and complexities. For instance, according to the National Alliance on Mental Illness, roughly 40% of incarcerated populations have mental health histories, compared with 20% of the general population. Among individuals with mental illness, 63% will receive no mental health services while incarcerated, thus leaving this risk factor untreated. Because mental health conditions are associated with a greater likelihood of chronic pain and poorer outcomes, patients could benefit from effective treatment that dually addresses pain and psychological symptoms via enhanced self-regulation. A second consideration pertains to corrections settings having a high percentage of patients with histories of substance use disorder or o","journal":"Pain Medicine","year":2023,"id":413884,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9079,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":226959,"name":"Sean Mackey","orcid":"0000-0001-7744-5348","position":1,"is_corresponding":false},{"id":540675,"name":"Noel Vest","orcid":"0000-0001-8014-9726","position":2,"is_corresponding":false},{"id":384723,"name":"Beth D. Darnall","orcid":"0000-0003-3590-511X","position":3,"is_corresponding":false},{"id":1195440,"name":"Aditya Banerjee","orcid":"0000-0002-3278-5709","position":0,"is_corresponding":true}],"reference_count":9,"raw_metadata":null,"created_at":"2026-07-19T01:22:01.321790Z","pmid":"37950495","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}