A new study led by researchers affiliated with Harvard University finds that older Black patients with advanced cancer are less likely than White patients to receive opioid medications for pain relief in the last weeks of life.
Researchers examined opioid prescription orders for 318,549 Medicare patients over the age of 65 who had poor-prognosis cancers and were nearing the end of life. Between 2007 and 2019, the group experienced a steady decline in access to opioids and a rapid expansion of urine drug screening. Within these broader trends, researchers found small but meaningful divergences between racial and ethnic groups.
Compared with White patients, Black patients were 4.3 percentage points less likely to receive any opioid and 3.2 percentage points less likely to receive long-acting opioids near the end of life. Researchers also found that when Black patients received opioids, they tended to receive lower doses.
The inequities were particularly stark for Black men. “We found that Black men were far less likely to be prescribed reasonable doses than White men were,” said the study’s senior author, Alexi Wright, a gynecologic oncologist and an associate professor at Harvard Medical School. “And Black men were less likely to receive long-acting opioids, which are essential for many patients dying of cancer. Our findings are startling because everyone should agree that cancer patients should have equal access to pain relief at the end of life.”
The full study, “Racial and Ethnic Disparities in Opioid Access and Urine Drug Screening Among Older Patients With Poor-Prognosis Cancer Near the End of Life,” was published on the website of the Journal of Clinical Oncology. It may be accessed here.