Minorities Less Likely to Get ER Narcotics
January 2nd 2008
I found this article earlier today and thought it would be interesting to share. Personally, I have always felt that doctors treated me differently. For some reason female doctors have been much more thorough…well, scratch that…it seems that younger doctors were. Every doctor I have been to that was older seemed like they had the attitude that if you aren’t bleeding and about to die then you are alright. But, that can all be coincidence and the simple fact that every doctor is different. Some of you may have the exact opposite experience.
But, this article is interesting because they looked at 150,000 different ER cases and found on average that blacks are given less pain pills than whites. Now, this can be a result of attitude. Maybe black men and women don’t show their pain as easily as others so doctors don’t think it is necessary. Sounds a little far fetched but raw data is what it is…
CHICAGO (AP) — Emergency room doctors are prescribing strong narcotics more often to patients who complain of pain, but minorities are less likely to get them than whites, a new study finds. Even for the severe pain of kidney stones, minorities were prescribed narcotics such as oxycodone and morphine less frequently than whites.
The analysis of more than 150,000 emergency room visits over 13 years found differences in prescribing by race and ethnicity in both urban and rural hospitals, in all U.S. regions and for every type of pain.
“The gaps between whites and nonwhites have not appeared to close at all,” said study co-author Dr. Mark Pletcher of the University of California, San Francisco.
The study appears in Wednesday’s Journal of the American Medical Association. Prescribing narcotics for pain in emergency rooms rose during the study, from 23 percent of those complaining of pain in 1993 to 37 percent in 2005.
The increase coincided with changing attitudes among doctors who now regard pain management as a key to healing. Doctors in accredited hospitals must ask patients about pain, just as they monitor vital signs such as temperature and pulse.
Even with the increase, the racial gap endured. Linda Simoni-Wastila of the University of Maryland, Baltimore, School of Pharmacy said the race gap finding may reveal some doctors’ suspicions that minority patients could be drug abusers lying about pain to get narcotics.
The irony, she said, is that blacks are the least likely group to abuse prescription drugs. Hispanics are becoming as likely as whites to abuse prescription opioids and stimulants, according to her research. She was not involved in the current study.
The study’s authors said doctors may be less likely to see signs of painkiller abuse in white patients, or they may be undertreating pain in minority patients.
Patient behavior may play a role, Pletcher said. Minority patients “may be less likely to keep complaining about their pain or feel they deserve good pain control,” he said.
Stricter protocols for prescribing narcotics may help close the gap.
A New York hospital recently studied its emergency patients and found no racial disparity in narcotics prescribed for broken bones. Montefiore Medical Center aggressively treats pain and is developing protocols for painkillers that dictate initial dosages and times to check with patients to see if they need more pain medicine, said Dr. David Esses, emergency department associate director at Montefiore.
Such standards may eliminate racial disparities, Esses said.
In the study, opioid narcotics were prescribed in 31 percent of the pain-related visits involving whites, 28 percent for Asians, 24 percent for Hispanics and 23 percent for blacks.
