Non-white communities had significantly less access to opioid medications commonly prescribed for moderate to severe pain than white communities over the decade beginning in 2011, according to a study by Weill Cornell Medicine researchers.
The findings, published Jan. 23 in Pain, stretched across all socioeconomic groups, and suggest that communities of color may be especially vulnerable to the unintended consequences of efforts to reduce unsafe use of opioid analgesics.
From 2011 to 2021, prescription opioid use dropped by about 50% across the United States as a likely sign of attempts to reduce overuse of the drugs, previous studies found. However, these declines coincided with neighborhood pharmacies and healthcare settings also carrying fewer opioid medications, likely making it harder for people to fill prescriptions needed for pain management. For some, that may have required traveling longer distances to get the medication they need or not getting the drugs at all, the authors suggested.
The study, led by Dr. Allison Ju-Chen Hu , postdoctoral associate of population health sciences, and Dr. Yuhua Bao , professor of population health sciences at Weill Cornell Medicine, examined access to opioid medication across communities based on their racial and ethnic makeup.
The research team analyzed data from the Drug Enforcement Administration from 2011 to 2021 that reported community distribution of morphine, oxycodone and hydrocodone. Combined, these drugs made up 70% of opioid prescriptions in the United States in 2017. The team analyzed communities defined by 3-digit zip-codes in all 50 states and the District of Columbia. The communities were classified as "majority white" or "majority non-white" based on whether 50% or more of the residents self-reported as non-Hispanic white. The authors also used the Social Deprivation Index to measure the socioeconomic status of each community.
Their analysis showed that there was an overall 40% to 45% lower per-capita distribution of commonly prescribed opioids in majority non-white communities as compared with majority white communities. "While opioid distributions were higher among communities with greater socioeconomic deprivation, differences between majority white and majority non-white communities persisted across all levels," the authors reported. This inadequate access to opioid analgesics in majority non-white communities may delay treatment even when it's considered "clinically appropriate," they wrote.
"Our findings highlight concerns that racially and ethnically minoritized communities, especially the most deprived communities, may have consistently experienced inadequate access to effective pain management amid rapid declines in opioid analgesics during this time," the authors concluded.
