ArticleDrug and alcohol dependence2021
Race, pain, and opioids among patients with chronic pain in a safety-net health system.
Article in Drug and alcohol dependence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Virtual Reality for Chronic Pain Management Among Historically Marginalized Populations: Systematic Review of Usability Studies.Journal of medical Internet research · 2023Pooled it
- Diversity inclusion in United States opioid pharmacological treatment trials: A systematic review.Experimental and clinical psychopharmacology · 2021Pooled it
- Trends in opioid prescribing after shoulder arthroplasty in an integrated health system: an analysis across racial and ethnic groups.Journal of shoulder and elbow arthroplasty · 2026Article
- Associations of community socioeconomic factors and opioid use disorder across an urban-to-rural spectrum in Pennsylvania: an electronic health record-based case-control study.Social psychiatry and psychiatric epidemiology · 2025Article
- Examining Racial/Ethnic Differences in Patterns of Opioid Prescribing: Results from an Urban Safety-Net Healthcare System.Journal of racial and ethnic health disparities · 2024Article
- Are There Racial Disparities in Perioperative Pain? A Retrospective Study of a Gynecological Surgery Cohort.Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · 2024Article
- Trajectories and predictors of high-occurrence pain flares in ambulatory cancer patients on opioids.JNCI cancer spectrum · 2024Article
- Usability and acceptability of virtual reality for chronic pain management among diverse patients in a safety-net setting: a qualitative analysis.JAMIA open · 2023Article
- The intersection of drug use discrimination and racial discrimination in the management of chronic non-cancer pain in United States primary care safety-net clinics: Implications for healthcare system and clinic-level changes.Drug and alcohol dependence · 2023Article
- Racial and Ethnic Disparities in Opioid Prescriptions for Patients with Abdominal Pain: Analysis of the National Ambulatory Medical Care Survey.Journal of clinical medicine · 2023Article
- The Experience of BIPOC Living with Chronic Pain in the USA: Biopsychosocial Factors that Underlie Racial Disparities in Pain Outcomes, Comorbidities, Inequities, and Barriers to Treatment.Current pain and headache reports · 2023Review
- Interactive Effects ofThe Journal of pharmacology and experimental therapeutics · 2022Article
- Recognizing and Addressing Health Care Disparities Among Black Populations.The primary care companion for CNS disorders · 2022Article
- Association of chronic non-cancer pain status and buprenorphine treatment retention among individuals with opioid use disorder: Results from electronic health record data.Drug and alcohol dependence reports · 2022Article
- Individual and Health Policy Factors Associated With Positive Heroin and Opioid Treatment Response: United States, 2018.American journal of public health · 2022Article
- Geographic Variation in the Use of Gabapentinoids and Opioids for Pain in a Commercially Insured Adult Population in the United States.Journal of pain research · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundRecent changes in opioid prescribing practices in the US may exacerbate disparities in opioid access among Black compared to White patients.
methodsTo evaluate racial disparities in opioid prescribing and stewardship, we used baseline data collected from 2017 to 2019 for a longitudinal cohort of patients with chronic non-cancer pain and a history of illicit substance use. Sociodemographic characteristics, pain, psychological distress, substance use, and opioid prescription practices were compared between Black and White participants. We conducted multivariable logistic regression with race as the outcome. We also compared yellow flag events (opioid-related emergency department visits, illicit substances on urine drug screens, provider-documentation of concerning behaviors) by race.
resultsOver half of participants analyzed were Black (57%) and the remainder White (43%). Participants with worse average pain in the past three months (adjusted odds ratio [AOR]:1.29, 95%CI:1.08-1.55, p = 0.006) had higher odds of being Black. Past-year injection drug use (AOR:0.39, 95%CI:0.16-0.94, p = 0.04) and a higher past-year maximum opioid dose (AOR per 10 morphine milligram equivalents (MME):0.99, 95%CI:0.98-1.00, p = 0.006) were associated with lower odds of being Black. We found no differences by race in the use of opioid stewardship measures or discontinuation of opioids based on yellow flag events.
conclusionLower past-year maximum MME dose, despite higher average pain and less injection drug use, may represent bias away from prescribing opioids for chronic pain among Black patients. This could be due to unmeasured implicit provider bias or patient-level factors (e.g., utilizing non-opioid pain coping strategies or being less likely to request additional opioids).
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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.