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Racial Disparities Observed in Opioid Monitoring

Black patients more often receive urine drug tests, less likely to receive pain specialist referral

Racial Disparities Observed in Opioid Monitoring

MONDAY, Feb. 18 (HealthDay News) -- For patients receiving opioids for non-cancer pain, racial disparities exist in opioid monitoring and follow-up treatment practices, according to a study published in the January issue of Pain.

Leslie R.M. Hausmann, Ph.D., from the University of Pittsburgh, and colleagues used electronic health records to ascertain opioid monitoring and follow-up treatment practices in a cohort of 1,646 white and 253 black patients who filled opioid prescriptions for non-cancer pain for 90 consecutive days or more at the Veterans Affairs Pittsburgh Healthcare System pharmacy (in 2007 and 2008). Participants were followed for 12 months.

The researchers found that 26.3 percent of patients had opioid agreements on file; pain was recorded in 71.7 percent of primary care follow-up visits; and 49.3 percent of patients underwent urine drug testing. Referrals were made to pain specialists for 21.2 percent of patients and to substance abuse specialists for 4.2 percent of patients. Pain was recorded less frequently for black patients than for white patients in adjusted comparisons. Among those who had at least one urine drug test, black patients, especially those on higher doses of opioids, were subjected to more urine tests. Black patients were also less likely to be referred to a pain specialist and more likely to be referred for substance abuse assessment, compared with white patients.

"Our study highlights the need to address racial disparities in the monitoring of patients on opioid regimens for the treatment of chronic pain," the authors write. "Addressing disparities in opioid monitoring practices may be a previously neglected route to reducing racial disparities in pain management."

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