Pain Management Discrimination

Black patients: prescribed opioids less frequently yet undergo more urine drug screenings. The Journal of Clinical Oncology reports on various healthcare disparities affecting older patients at end of life. Findings from over 300,000 decedents >65 years with poor-prognosis cancers include:

• Received opioids, compared to White patients:
  • Black patients: -4.3 (percentage points)
  • Hispanic patients: -3.6
• Received long acting opioids, compared to White patients:
  • Black patients: -3.1
  • Hispanic patients: -2.2
• Received lower daily doses, compared to White patients:
  • Black patients: -10.5
  • Hispanic patients: -9.1
• Total doses, compared to White patients:
  • Black patients: -210 MMEs
  • Hispanic patients: -179 MMEs

The study concluded, “there are ongoing racial and ethnic inequities in opioid access among Medicare-insured patients dying of cancer not explained by clinical or contextual factors, potentially representing prejudice and structural racism within the health care system that must be addressed.” Lead author of the study, Andrea Enzinger, MD, commented, “Over the past decade, there has been a seismic shift in prescribing practices and sharp declines in access to these medications for patients with cancer. But we know very little about the current state of disparities in access in this environment of increased regulation, and about the magnitude of disparities among patients with terminal cancer.” Dr. Enzinger is an assistant professor of Medical Oncology, Dana-Farber Cancer Institute in Boston, Massachusetts.

 

Access the journal article.

Read the press release.

Other Categories:

• chronic pain

• Discrimination

• geriatric pain management

• opioid therapy

• opioids

• pain management

• pain policy

• Racial disparity

• urine drug testing (UDT)