Yale Research Finds Racial Disparity In Screening Of Opioid Patients

Black patients who are prescribed opioids for chronic pain are more likely than whites to be tested for illegal drug use, and to lose their prescriptions when they test positive, a new Yale report shows.

The findings were based on a Yale University-led analysis of more than 15,000 patients prescribed opioids by the Veteran Administration between 2000 and 2010.

The research team found a significant racial disparity in the screening of patients for illicit marijuana and cocaine use after they began taking opioids, a practice recommended by the Centers for Disease Control and Prevention.

The study suggests that doctors are more often allowing white patients to continue using opioids in the face of evidence that they are using other illegal drugs, “even though research has shown that whites are the group at highest risk for overdose and death” from prescription opioids, says study author Julie Gaither, a pediatrics instructor at the Yale School of Medicine

“There is no mandate to immediately stop a patient from taking prescription opioids if they test positive for illicit drugs,” Gaither said. “It’s our feeling that without clear guidance, physicians are falling back on ingrained stereotypes, including racial stereotyping.”

White people accounted for 79 percent of the 42,250 people who died of opioid overdoses in the United States in 2016, according to the Henry J. Kaiser Family Foundation. The ratio was the same in Connecticut, where 855 people died of opioid overdoses that year, 677 of them white.

Still, according to the Yale researchers, black patients are more than twice as likely as white patients to be tested for marijuana and cocaine at the one-, three- and six-month marks after beginning opioid treatment to manage long-term pain.

While 90 percent of patients who tested positive for marijuana or cocaine continued to receive their opioid prescriptions, black patients were more frequently stripped of their prescriptions.

After a positive marijuana test, black patients were twice as likely as whites to have opioids discontinued, the study found.

After a positive cocaine test, black patients were three times as likely to have opioids cut off.

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