In the early days of the national opioid crisis, doctors more often prescribe opioids to white patients complaining of new low back pain, rather than prescribing opioids to black, Asian, and Hispanic patients, when these powerful painkillers were prescribed Surge, but their danger is not great. According to a study by the University of California, Los Angeles, this is obvious.
The results of the study indicate that doctors may often allocate pain treatment unequally based on race and ethnicity. The study shows that doctors are more likely to prescribe non-steroidal anti-inflammatory drugs or non-steroidal anti-inflammatory drugs—a less effective alternative to people of color who come to treat back pain.
“This seems to be a case of doctors’ differential treatment of pain or prejudice, in which some patients require opioids for pain and others do not,” said Dr. Dan Ly, an assistant professor of medicine and author of the study. At the David Geffen School of Medicine at UCLA. “In hindsight, the fact that more and more white patients use opioids for a long time is dangerous. This fact does not exempt doctors from such differential treatment.”
The paper was published today in the peer-reviewed JAMA Health Forum.
Ly examined nationwide medical claims data from 2006 to 2015, which involved approximately 275,000 medical insurance beneficiaries 66 years of age or older who were experiencing new low back pain. Approximately 81% of these patients were white, 6% were black, 6% were Asian/Pacific Islander, and 8% were Hispanic.
Ly focused on how individual doctors prescribe opioids differently based on the patient’s race and ethnicity, and found that on average, these drugs were allocated to 11.5% of white patients, while about 10% of black patients and 9% of Asian/ Pacific Islander patients and 10.5% of Hispanic patients.
Among patients who appeared to have severe or persistent pain—measured as five or more visits to the doctor for back pain within a year—the difference was even more pronounced: 36% of white patients took opioids, compared with approximately 30% of whites The patient took opioids. Black patients, 21% Asian/Pacific Islanders and 24% Hispanics. Ly said doctors also tend to prescribe opioids to white patients earlier.
In contrast, doctors prescribe NSAIDs for 25% of black patients, 25% of Asian/Pacific Islander, and 28% of Hispanic patients, but only 24% of whites—similarly, for back pain The more frequent patients, the greater the difference.
The study also found that white patients with new-onset low back pain were more likely to subsequently develop long-term dependence on opioids than black, Asian/Pacific Islander or Hispanic patients.
Ly said that one possible reason for these differences in prescriptions is that doctors may lack confidence that patients of color will not abuse opioids, although studies have shown that there is no difference in opioid abuse rates between patients of color and white patients. He said it is also possible that patients of color need opioids more frequently than white patients, although there is no evidence to prove this.
Ly pointed out that because this is an observational study, there may be other unobservable factors that have contributed to the difference in prescriptions. The survey results do not include the results of physical examinations that may affect the prescription decision, and the data does not include over-the-counter drugs.
The National Institute on Aging funded this research.