Racial and Ethnic Disparities Associated With the Use of Opioids for Chronic Non-cancer Pain

TL;DR

This study finds racial disparities in opioid use for chronic pain, with Black patients less likely to receive opioids compared to White patients.

Contribution

The study reveals persistent racial disparities in opioid prescriptions for chronic non-cancer pain despite national efforts to reduce opioid use.

Findings

Black patients had lower odds of receiving opioids for chronic non-cancer pain compared to White patients.

Opioid use for chronic non-cancer pain has declined overall, but disparities remain.

Non-opioid treatments were used by the majority of patients across all racial groups.

Abstract

Chronic non-cancer pain (CNCP) affects a substantial proportion of adults in the United States and is commonly managed using both opioid and non-opioid therapies. This study examined racial and ethnic disparities associated with opioid use for CNCP using nationally representative data. With national efforts and evolving clinical guidelines to reduce opioid use for non-cancer pain, it is not clear if these efforts have helped everyone equally. The objective of the study was to examine racial and ethnic disparities associated with opioid use as a treatment strategy for CNCP. A serial cross-sectional study was conducted using the nationally representative Medical Expenditure Panel Survey (MEPS) data (2016-2021) to estimate opioid and non-opioid treatment choices for CNCP. Racial/ethnic disparities were evaluated by comparing non-Hispanic White patients (whites) with non-Hispanic Black patients (blacks), non-Hispanic Asian/Native American/other/multiple patients (Asians/others), and Hispanic patients. In a sample of 7521 individuals (weighted sample = 14.12M) from 2016 to 2021 with CNCP, our study unveiled that 5.51% utilized opioid therapies while 94.49% utilized non-opioid treatments. Results indicated racial disparities were evident even with declining opioid utilization, as Black individuals exhibited lower estimated odds of opioid utilization (OR = 0.759, 95% CI: 1.240-1.686, p < 0.05) compared to the White population. Other comparisons were not significant. Results revealed significant racial disparities in opioid utilization for CNCP, with Black patients less likely to receive opioid therapy compared to White patients, despite overall declining opioid use.

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