Study Finds Discrepancy in Prescribing Painkillers Between Whites and Ethnics

US hospitals are more likely to give painkillers to white patients than other ethnic groups despite studies in the 1990s that highlighted the problem, according to a study released Wednesday.

During 1993-2005, there was a steady increase in the use of opioid painkillers to help emergency room patients complaining of pain, according to the study of nearly 375,000 hospital visits by a team of researchers led by Mark Pletcher of the University of California-San Francisco.

At the beginning of the period, only 23 percent of all patients visiting the hospital for pain were given opioids, said the study published by the Journal of the American Medical Association.

At the end of the period, 37 percent were medicated with opioids.

However, there was a consistent difference between how often whites received the painkillers and how often African-Americans and Hispanics received them.

On average during the 13 years, 31 percent of whites were given opioids, while only 24 percent of Hispanics and 23 percent of blacks got them. For Asians and others, the rate was 28 percent.

And despite the overall rise in administering opioids over the period, the racial gap remained consistent at the end: in 2005, opioid prescription rates were 40 percent for whites, and 32 percent for all other ethnic groups.

For example, a white person going to a hospital emergency room in Los Angeles with a major arm or leg bone fracture was twice as likely to receive an opioid painkiller as a Hispanic with the same injury, the study said.

While the study pointed out that the problem remains despite 1990s studies that showed the same phenomenon and the 1995 issuance of improvement guidelines for the treatment of acute and cancer pain, it could not fully explain the treatment discrepancy.

"Causes of disparities in medical care ... are complex, and simple racial/ethnic bias is unlikely to fully explain the problem," the study said.

"Race and ethnicity influence all aspects of the therapeutic relationship, including how (or whether) patients articulate painful symptoms to their physicians, what kinds of treatment are requested, and how physicians and allied health staff interpret and respond to those symptoms," it said.

It notes that while doctors report in surveys that they treat patients of different races equally, the doctors might interpret differently the patients' expressions of pain symptoms and their desire for pain medications.

Source-AFP
LIN/M