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 ER visits over 13 years found differences in prescribing by race and ethnicity in 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.
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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.
Racist stereotypes are ingrained into people from birth, and as long as they persist there will be disparities between how people of different races are treated in this country. Passing a law saying "Don't discriminate" isn't enough while we're bombarding people with the message that certain races are more criminal than others. People are left with the impression that these stereotypes are real problems--despite the fact that they have little to no basis in reality, as the above idea that blacks are more likely to abuse painkillers--and that they are therefore justified in doing their own racial classification.
It's especially a problem because people don't necessarily make these decisions and connections consciously, but they're there nonetheless.
"If anybody argues they have no social biases that sway clinical practice, they have not been thoughtful about the issue or they're not being honest with themselves," [Dr. Thomas Fisher] said.
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