On Disparities As to Opioids

Maybe it is because much of my professional work involves disparities and the social determinants of health, while much of my academic work is currently devoted to thinking about pain, stigma, and the widespread undertreatment of pain, but I was just shocked, shocked I say, to hear of the study in the latest JAMA.  The study found that racial and ethnic minorities were less likely to be prescribed opioids for pain in emergency rooms.

An editorial accompanied the study, written by Allyn Taylor (who authored a piece on the global undertreatment of pain in the most recent Am. J. L. Med. & Ethics), Lawrence Gostin, and Katrina Pagonis.  The editorial is refreshing in its emphasis on attitudinal and access barriers, in addition to the legal/regulatory barriers that are all too often deemed to be the primary cause of the undertreatment of pain.  This latter approach is flawed, IMO, and I will endeavor to explain why in my dissertation.

Something to note about this study is that it tracked opioid dispensation in emergency rooms, which obviously implicates acute pain.  There is virtually no question that acute pain is generally treated better than chronic pain, so if these disparities are observed in acute pain scenarios, one can only imagine the depth of the problems relating to the treatment of chronic pain in racial and ethnic minorities and other disadvantaged or marginalized populations.