UCLA Study Finds a Racial Bias Among Physicians in Prescribing Pain Medicine

A new study by Dan P. Ly, an assistant professor in the Division of General Internal Medicine and Health Services Research at the Geffen School of Medicine at the University of California, Los Angeles, finds that physicians prescribed opioids more often to their White patients who complained of new-onset low back pain than to their Black, Asian, and Hispanic patients during the early days of the national opioid crisis, when prescriptions for these powerful painkillers were surging but their dangers were not fully apparent. The research also found that physicians were more likely to prescribe non-steroidal anti-inflammatory drugs, or NSAIDs — a less-powerful alternative — to their patients of color who came to them for back pain care.

Dr. Ly examined nationwide medical claims data from 2006 through 2015 for about 275,000 Medicare beneficiaries who were 66 or older and were experiencing new-onset low back pain. He found that Ly found that, on average, these drugs were dispensed to 11.5 percent of White patients, versus about 10 percent of Black patients. Among patients who seemed to have severe or longer-lasting pain — measured as five or more visits to the doctor for back pain in a year — the differences were starker: 36 percent of White patients were prescribed opioids, versus about 30 percent of Black patients. Physicians also tended to prescribe opioids sooner to their White patients.

“This appears to be a case of differential treatment of pain or bias by physicians, in which the pain of certain patients deserves opioids and the pain of others does not,” said Dr. Ly. “The fact that, in hindsight, more White patients developed dangerous long-term opioid use doesn’t absolve physicians of this differential treatment.”

The full study, “Association of Patient Race and Ethnicity With Differences in Opioid Prescribing by Primary Care Physicians for Older Adults With New Low Back Pain,” was published in the JAMA Health Forum. It may be accessed here.

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