ArticleDrug and alcohol dependence2018
Racial disparities in discontinuation of long-term opioid therapy following illicit drug use among black and white patients.
Article in Drug and alcohol dependence, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed, 3 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Urine drug testing among Medicaid enrollees initiating buprenorphine treatment for opioid use disorder within 9 MODRN states.Drug and alcohol dependence · 2023Pooled it
- CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2022Guideline
- An Evaluation of Opioid Use in Black Communities: A Rapid Review of the Literature.Harvard review of psychiatryPooled it
- Negative Descriptors of Patients With Sickle Cell Disease in the Electronic Health Record.JAMA network open · 2026Article
- Comparison of trends in CPS reports of child maltreatment and child maltreatment-related mortality across time, place and race/ethnicity.American journal of epidemiology · 2026Article
- Prescription Monitoring Program Mandates and Opioids Dispensed to Patients Dying of Cancer.JCO oncology practice · 2026Article
- Sociodemographic differences in discontinuation of high-risk medications: a retrospective cohort study.npj aging · 2025Article
- The role of racial and socioeconomic status bias on medication prescribing practices: a qualitative study of family physician perspectives.BMC primary care · 2025Article
- Association between rapid opioid reduction or discontinuation and self-harm, suicide attempt, and suicide death among patients receiving high-dose, long-term opioid therapy in North Carolina, 2006-2018.American journal of epidemiology · 2025Article
- Disparities in fatal and non-fatal opioid-involved overdoses among middle-aged non-Hispanic Black Men and Women.Journal of racial and ethnic health disparities · 2025Article
- Pharmacoequity measurement framework: A tool to reduce health disparities.Journal of managed care & specialty pharmacy · 2025Article
- Provision of medications to treat opioid use disorder via a mobile health unit: A scoping review.Journal of substance use and addiction treatment · 2024Article
- Potential role of cannabis in ameliorating observed racialized disparities in cancer pain management.Journal of the National Cancer Institute · 2024Article
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- Diagnostic profiles associated with long-term opioid therapy in active duty servicemembers.PM & R : the journal of injury, function, and rehabilitation · 2024Article
- Opioid prescription rates associated with surgery among adolescents in the United States from 2015 to 2020.Paediatric anaesthesia · 2023Article
- Minnesota Data Sharing May Be Model For Near-Real-Time Tracking Of Drug Overdose Hospital And ED Trends.Health affairs (Project Hope) · 2023Article
- Opioid and stimulant attributed treatment admissions and fatal overdoses: Using national surveillance data to examine the intersection of race, sex, and polysubstance use, 1992-2020.Drug and alcohol dependence · 2023Article
- Outcomes of State Targeted/Opioid Response Grants and the Medication First Approach: Evidence of Racial Inequities in Improved Treatment Access and Retention.Substance abuse · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAmong patients prescribed long-term opioid therapy (LTOT) for chronic pain, no study has yet examined how clinicians respond to evidence of illicit drug use and whether the decision to discontinue opioids is influenced by a patient's race.
methodsAmong outpatients of black and white race initiating LTOT through the VA between 2000 and 2010, we reviewed electronic medical records to determine whether opioids were discontinued within 60 days of a positive urine drug test. Logistic regression was used to examine differences by race.
resultsAmong 15,366 patients of black (48.1%) or white (51.9%) race initiating LTOT from 2000 to 2010, 20.5% (25.5% of blacks vs. 15.8% of whites, P <. 001) received a urine drug test within the first 6 months of treatment; 13.8% tested positive for cannabis and 17.4% for cocaine. LTOT was discontinued in 11.4% of patients who tested positive for cannabis and in 13.1% of those who tested positive for cocaine. Among patients testing positive for cannabis, blacks were 2.1 times more likely than whites to have LTOT discontinued (adjusted odds ratio [AOR] 2.06, 95% confidence interval [CI] 1.04-4.08). Among patients testing positive for cocaine, blacks were 3.3 times more likely than whites to have LTOT discontinued (AOR 3.30, CI 1.28-8.53).
conclusionsAmong patients testing positive for illicit drug use while receiving LTOT, clinicians are substantially more likely to discontinue opioids when the patient is black. A more universal approach to administering and responding to urine drug testing is urgently needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.