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Racial Disparity Found in Prescribing of Opioid Painkillers Like Fentora

Jan 9, 2008 | Parker Waichman LLP Opioid medications, like Fentora, are powerful painkillers that are increasingly being prescribed in emergency rooms.  A new study finds that white patients are more likely to receive the pain killing medications than minorities, possibly due to stigmas related to addiction.  Since the 1990s, as health officials began focusing on under-treated pain, a growing number of patients have been given opioids in a variety of medical settings, the study noted.  But the researchers, whose report appears in the January 2nd Journal of the American Medical Association, wanted to see if the increase extended to emergency rooms and also wanted to know if there was still a tendency among doctors to withhold opioid drugs from blacks and nonwhite Hispanics.  According to the study, the tendency still exists.

Dr. Mark J. Pletcher of the University of California, San Francisco led the research.  Pletcher and his team based their findings on a review of over 150,000 pain-related emergency room visits nationwide over 13 years and discovered in 1993, 23 percent of patients treated in emergency rooms complaining of pain were given opioids; in 2005, the figure was 37 percent.  When nonwhites are treated, figures change.  Researchers found if two groups of one dozen patients sought treatment for pain—one group all white; the other all minority—one fewer patient in the minority group would receive medication.  Researches said white patients could be given opioids too often, but sounded doubtful, saying, “A more plausible explanation for our findings invokes a true disparity in prescribing, with differential under-treatment of pain in minority patients.”

This is not the only issue of disparate treatment in U.S. hospitals based on.  A study published last week revealed that nearly one-third of all patients experiencing misfiring or quivering hearts in U.S. hospitals do not receive life-saving defibrillator shocks within the critical first two minutes of cardiac arrest.  This, despite the fact that The American Heart Association recommends stopped hearts be shocked within the first two minutes.  The study confirming the importance of the two-minute period for survival was published in the New England Journal of Medicine, which also ran an accompanying editorial piece indicating a person might be better off suffering cardiac arrest in a casino rather than a hospital.  Researchers from 369 hospitals in the National Registry of Cardiopulmonary Resuscitation found that being black or having a cardiac arrest outside of regular weekday working hours also significantly delayed the time it took for hospital workers to shock the heart.  Paul Chan of the Mid-America Heart Institute in Kansas City, Missouri led the study in the New England Journal of Medicine.

Disparity appears among class groups as well.  A recent study found 72 percent of those receiving free drug samples from their physicians had income in excess of 200 percent above the poverty level, while 28 percent had income below poverty level.† William Shrank, a physician at Boston's Brigham and Women's Hospital who studies pharmaceutical use in large populations, said the study helps debunk the assertion that drug samples help the needy.

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