NEW YORKBlacks, Hispanics, and other minorities are less likely than whites to receive appropriate analgesia, as illustrated in the cancer literature and anecdotal reports from those who work with minority populations, said Stacie T. Pinderhughes, MD. "This is a high-risk group with regard to adequate and appropriate treatment of pain," said Dr. Pinderhughes, assistant professor of geriatrics and internal medicine, Mount Sinai School of Medicine, New York.
Studies show that physicians will evaluate pain equally, regardless of the patient’s pain or ethnicity, Dr. Pinder-hughes said at an American Medical Association media briefing on pain management. However, when it comes to treatment, there appears to be a significant disparity in prescribing practices.
In one study of cancer patients, 65% of minority patients did not receive guideline-recommended analgesic prescriptions. By contrast, 50% of nonminority patients received appropriate pain therapy (Ann Intern Med 127:813-816, 1997).
A variety of factors may influence whether or not minorities receive appropriate prescriptions. One major barrier to treatment is limited access to opioids in neighborhood pharmacies. A colleague of Dr. Pinderhughes at Mount Sinai found that pharmacies in predominantly minority neighborhoods were less likely to stock opioid pain medications than pharmacies in predominantly nonmi-nority neighborhoods (N Engl J Med 342:1023-1026, 2000).
Dr. Pinderhughes told the story of a Puerto Rican-American assistant who 2 years ago brought her best friend home to die of metastatic cancer. She went to a local pharmacy in Spanish Harlem, which could not fill her friend’s morphine(Drug information on morphine) prescriptionnor could four other pharmacies in the neighborhood.
"She had to go back to Mount Sinai, ultimately, to get her prescription filled, so her best friend could die 2 days later at home in relative comfort," Dr. Pinder-hughes recalled.