ArticleDrug and alcohol dependence2023
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.
Article in Drug and alcohol dependence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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
9 citing papers in PubMed, 13 citations in OpenAlex.
- Negative Descriptors of Patients With Sickle Cell Disease in the Electronic Health Record.JAMA network open · 2026Article
- Association of Everyday Discrimination With Drug Use During the COVID-19 Pandemic in the All of Us Research Program.Psychiatry investigation · 2026Article
- Patient-centred educational interventions for assessing and managing cancer-related pain relevant to minority ethnic populations: A mixed-methods systematic review.Palliative care and social practice · 2026Review
- Ethnic disparities in opioid prescribing for cancer pain and associated emergency department visits and hospital admissions in the last three months of life: a retrospective cohort study.British journal of cancer · 2025Article
- Inequities in Opioid Administration by Race and Ethnicity for Hospitalized Patients With and Without Substance Use Disorders.Journal of general internal medicine · 2025Article
- Disparities in Postoperative Pain Management: A Scoping Review of Prescription Practices and Social Determinants of Health.Pharmacy (Basel, Switzerland) · 2025Review
- The Role of the Multidisciplinary Team for Opioid Stewardship: A Scoping Review.Journal of multidisciplinary healthcare · 2025Review
- Examining the Direct and Mediated Associations Between Perceived Discrimination and Prescription Opioid Misuse Among Individuals with Chronic Pain.Stigma and health · 2024Article
- The Clinical Evolutions of Surveillance and Violence During Three Contemporary US Crises: Opioid Overdose, COVID-19, and Racial Reckoning.Culture, medicine and psychiatry · 2024Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundClinicians' bias related to patients' race and substance use history play a role in pain management. However, patients' or clinicians' understandings about discriminatory practices and the structural factors that contribute to and exacerbate these practices are underexamined. We report on perceptions of discrimination from the perspectives of patients with chronic non-cancer pain (CNCP) and a history of substance use and their clinicians within the structural landscape of reductions in opioid prescribing in the United States.
methodsWe interviewed 46 clinicians and 94 patients, using semi-structured interview guides, from eight safety-net primary care clinics across the San Francisco Bay Area from 2013 to 2020. We used a modified grounded theory approach to code and analyze transcripts.
resultsClinicians discussed using opioid prescribing guidelines with the goals of increased opioid safety and reduced bias in patient monitoring. While patients acknowledged the validity of clinicians' concerns about opioid safety, they indicated that clinicians made assumptions about opioid misuse towards Black patients and patients suspected of substance use. Clinicians discussed evidence of discrimination in opioid prescribing at the clinic-wide level; racialized stereotypes about patients likely to misuse opioids; and their own struggles to overcome discriminatory practices regarding CNCP management.
conclusionWhile clinicians and patients acknowledged opioid safety concerns, the practical application of opioid prescribing guidelines impacted how patients perceived and engaged with CNCP care particularly for patients who are Black and/or report a history of substance use. We recommend healthcare system and clinic-level interventions that may remediate discriminatory practices and associated disparities.
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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.