Disparities/Minority Health

White patients are more likely than black patients to receive opioids to relieve chronic nonmalignant pain

About one in five primary care patients report suffering from persistent pain. White patients suffering from chronic nonmalignant pain are nearly three times more likely to take opioid analgesics than black patients. However, both white and black patients are equally likely to receive nonopioid analgesics, according to a study supported in part by the Agency for Healthcare Research and Quality (HS10861).

Researchers surveyed 397 black and white patients who suffered from nonmalignant pain for more than 3 months and their treating physicians at 12 academic medical centers. Blacks reported higher pain scores than whites (6.7 vs. 5.6 on a scale of 0 to 10). However, white patients were more likely to be taking opioid analgesics than blacks (46 vs. 32 percent). There were no differences by race in the use of other treatments such as physical therapy and nonsteroidal anti-inflammatories or in the use of specialty referrals. Similarly, insurance status, age, sex, educational level, and socioeconomic status had no bearing on the different types of treatment prescribed.

These findings suggest that patient race plays a significant role in the management of chronic nonmalignant pain in the primary care settings. Although disparities in opioid prescribing have been described in the acute and hospital setting, this is the first study to demonstrate this racial disparity in the primary care setting.

More details are in "Racial differences in opioid use for chronic nonmalignant pain," by Ian Chen, M.D., James Kurz, M.D., Mark Pasanen, M.D., and others, in the Journal of General Internal Medicine 20, pp. 593-598, 2005.

Editor's Note: A related article reveals disparities between black and white patients in the types of screening tests, exams, and counseling conducted during primary care office visits. For details, see Franks, P. Fiscella, K., and Meldrum, S. (2005). "Racial disparities in the content of primary care office visits." (AHRQ grant HS10910). Journal of General Internal Medicine 20, pp. 599-603.

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