Monday, October 10, 2005

In pain? Head for a better neighborhood.

According to a new study from the University of Michigan Health System, minorities and people with low incomes have less access to pain medication from their local pharmacies than do well-off white people.

The study, which compared the availability of opioid pain relievers in pharmacies from different areas, found that these drugs were more readily available in upscale ZIP codes than in poorer neighborhoods. While researchers point out that most of the pharmacies had "sufficient" supplies of medication--defined as at least one drug in each of three categories--the gap in the number of local pharmacies that stocked sufficient supplies was significant: 86.9% vs. 54.2%.

Inadequate pain relief is a problem across the country, which makes it especially distressing to learn that one group is particularly underserved in this regard.

The study is published in today's issue (vol 6, issue 10) of the Journal of Pain.


marin gillis said...

Here is the abstract:

Kristin Nelson said...

Did the study address confounding factors such as the idea that pharmacies stock what they get called on to provide so that what we might be seeing is really that people in lower income neighborhoods don't get prescriptions for these drugs at the same rate as people in higher income neighborhoods? What that would reflect then is that lower-income people have less access to health care and that's not a new finding.

Sue Trinidad said...

The researchers were actually prompted to look into this question by comments from their minority patients who were unable to have their prescriptions for pain meds filled at their local pharmacies. It seems likely that there is a connection between general utilization/access patterns to health care in general, but there are some interesting findings from this study.

From the article:

"The most common reason cited as a barrier to opioid availability was low demand (93.1%). However, this did not vary by opioid analgesic sufficiency, pharmacy racial composition, pharmacy type, level of zip code urbanization, level of opioid analgesic supply, median age, household income, or proportion of residents ≥65 years old. The fear that patients might use opioid analgesics for illicit purposes was the second most prevalent barrier identified (8.5%). Concern with illicit opioid analgesic use was more likely to be reported as a barrier by pharmacies with insufficient opioid analgesic supplies when compared with those with sufficient supplies (30.3% vs 4.3%; P < .01). Again, this did not vary by pharmacy racial composition, pharmacy type, level of zip code urbanization, median age, household income, or proportion of residents ≥65 years old."