Researchers Examine Whether Racial Discrimination in Medical Settings is Protective for Blacks Against Opioid Pain Reliever Misuse

In the United States, whites are more likely to misuse opioid pain relievers (OPRs) than blacks are, and blacks are less likely to be prescribed OPRs than whites are. In a study published in Plos One, researchers examined whether racial discrimination in medical settings is protective for blacks against misuse, therefore mediating black and white disparities in misuse.

Researchers used data from 3,528 black and white adults in the Coronary Artery Risk Development in Young Adults study. They employed causal mediation methods, with race as the exposure, lifetime discrimination in medical settings prior to the year 2000 as the mediator, and OPR misuse after 2000 as the outcome.

They found that black participants were more likely to report discrimination in a medical setting and less likely to report OPR misuse. The mediation models suggest that when everyone is not discriminated against, the disparity is wider with black persons than their white counterparts. These results suggest that racial discrimination in a medical setting is a risk factor for OPR misuse rather than being protective, and thus could not explain the black-white disparity in OPR misuse.

“While our study did not suggest that this type of discrimination is related to the black/ white disparity in OPR misuse, we hope that it informs future research asking big questions about what drives these patterns in opioid misuse,” said Samuel Swift, Ph.D., lead authors of the study, who is an alumnus of the Ph.D. in Epidemiology and Population Health program at the Department of Public Health Sciences.

Co-authors of the study also included Maria Glymour from the University of California in San Francisco, Sc.D., M.S., Tali Elfassy, Ph.D., and Daniel Feaster, Ph.D., both from the Miller School of Medicine's Department of Public Health Sciences, Cora Lewis, M.D., M.S.P.H., from the University of Alabama, Catarina Kiefe, Ph.D., M.D., from the University of Massachusetts, Stephen Sidney, M.D., M.P.H., from Kaiser Permanente, Sebastian Calonico, Ph.D., M.A., from Columbia University, Zinzi Baile, M.P.H., from the Sylvester Comprehensive Cancer Center, and Adina Zeki Al Hazzouri, Ph.D., M.Sc., from Columbia University.

Written by Amanda Torres

Published on January 21, 2020