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Pain Management Needs In Minority And Low-Income Neighborhoods Inadequately Served


Study: Pharmacies In Minority And Low-Income Areas Less Likely To Carry Adequate Opioid Pain Medications

A study in the Oct. 2005 edition of the Journal of Pain finds that minority and poor neighborhoods are likely to lack access to pain medications. The University of Michigan Health System announced on Oct. 10, 2005 ( "Pharmacies In Minority And Low-Income Areas Less Likely To Carry Sufficient Supplies Of Pain Medications"):
"In a wide-reaching study of 95 pharmacies in ZIP codes with predominantly white populations and 93 pharmacies in ZIP codes with predominantly minority populations, researchers at the University of Michigan Health System's Department of Anesthesiology found a pronounced gap in the availability of prescription opioid analgesic medications.
"The study, which appears in the new issue of the Journal of Pain, found that Michigan pharmacies in predominantly minority areas were significantly less likely to have sufficient supplies of prescription opioid analgesic medications - drugs that include oxycodone, morphine and methadone - when compared with predominantly white areas.
"In addition, the odds of not having sufficient supplies of opioid analgesics - also known as narcotics - are significantly higher among pharmacies in low-income areas compared with high-income areas, regardless of the racial makeup in the vicinity.
"'The key finding is that there are differences in the ability to obtain pain medications in local pharmacies, with the lowest availability in minority and low-income areas,' says lead author Carmen R. Green, M.D., associate professor in the U-M Health System's Department of Anesthesiology and pain specialist at U-M's Center for Interventional Pain Medicine. 'The result of this disparity is that vulnerable populations are at increased risk for insufficient and lesser-quality pain care. For the pharmacies located in higher-income ZIP codes, those in white ZIP codes were more than 13 times more likely to have sufficient supplies than those in minority ZIP codes. When looking at those in lower-income ZIP codes, those in white ZIP codes were 54 times more likely than pharmacies in minority ZIP codes to have sufficient supplies.'"

An abstract of the article, "Differences In Prescription Opioid Analgesic Availability: Comparing Minority And White Pharmacies Across Michigan," from the Journal of Pain's website appears below.

"Differences in Prescription Opioid Analgesic Availability: Comparing Minority and White Pharmacies Across Michigan
"Carmen R. Green, S. Khady Ndao-Brumblay, Brady West, Tamika Washington
"Abstract "Little is known about physical barriers to adequate pain treatment for minorities. This investigation explored sociodemographic determinants of pain medication availability in Michigan pharmacies. A cross-sectional survey-based study with census data and data provided by Michigan community retail pharmacists was designed. Sufficient opioid analgesic supplies was defined as stocking at least one long-acting, short-acting, and combination opioid analgesic. Pharmacies located in minority (?70% minority residents) and white (?70% white residents) zip code areas were randomly selected by using a 2-stage sampling selection process (response rate, 80%). For the 190 pharmacies surveyed, most were located in white areas (51.6%) and had sufficient supplies (84.1%). After accounting for zip code median age and stratifying by income, pharmacies in white areas (odds ratio, 13.36 high income vs 54.42 low income) and noncorporate pharmacies (odds ratio, 24.92 high income vs 3.61 low income) were more likely to have sufficient opioid analgesic supplies (P < .005). Racial differences in the odds of having a sufficient supply were significantly higher in low income areas when compared with high income areas. Having a pharmacy located near a hospital did not change the availability for opioid analgesics. Persons living in predominantly minority areas experienced significant barriers to accessing pain medication, with greater disparities in low income areas regardless of ethnic composition. Differences were also found on the basis of pharmacy type, suggesting variability in pharmacist’s decision making.
"Perspective
"Michigan pharmacies in minority zip codes were 52 times less likely to carry sufficient opioid analgesics than pharmacies in white zip codes regardless of income. Lower income areas and corporate pharmacies were less likely to carry sufficient opioid analgesics. This study illustrates barriers to pain care and has public health implications."


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