Study: Black patients more closely monitored for opioid abuse

Physicians are more likely to monitor black patients prescribed opioid painkillers, even though research suggests that white patients are more likely to abuse the drugs, according to a study published in the Annals of Family Medicine.

The observational study, led by Yale University School of Medicine instructor Dr. William C. Becker, was based on 1,612 patients receiving long-term opioid treatment. Researchers found that black patients were significantly more likely than white patients to be scheduled for regular office visits and have restrictions put on early prescription refills–two recommended strategies to reduce the risk of opioid misuse. Black patients were also more likely to receive urine drug testing, but the difference was not statistically significant when adjusted for other factors.

The difference in monitoring appeared to be a “reverse disparity,” in which members of a traditionally vulnerable group receive care more in line with recommendations, the authors wrote. But they also pointed to studies suggesting that doctors underestimate the severity of pain in black patients and prescribe opioids more commonly for white patients.

“Taken together, these data indicate physicians are more cautious about initiating opioid therapy in black patients and, once the medication is started, monitor black patients more closely than whites,” they wrote.

Overall, monitoring of long-term opioid treatment was poor, the authors wrote, and the results suggest that doctors are “inappropriately lax in monitoring white patients,” whose risk of prescription drug abuse is greater than in other racial or ethnic groups.