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White patients are more likely than Black patients to be given opioid medication for pain in US emergency departments

White people who visit hospital emergency departments with pain are 26% more likely than Black people to be given opioid pain medications such as morphine. This was a key finding from our recent study, published in the Journal of General Internal Medicine. We also found that Black patients were 25% more likely than white patients to be given only non-opioid painkillers such as ibuprofen, which are typically available over the counter.

afraid_of_zombies ,

I feel like I have been hearing about this for a decade and yet no one has pinpointed the cause according to the article. Weird.

neptune ,

www.ncbi.nlm.nih.gov/pmc/articles/PMC2576060/

“In both the bivariate and multivariable models, black race was a significant variable associated with underestimation of pain by physicians”

Desistance ,
@Desistance@lemmy.world avatar

One of the very few cases where discrimination saved people from drug addiction.

MrSpArkle ,

Yeah this one’s an unintentional blessing.

PetDinosaurs , (edited )

While I’m confident that this is correct, we need to stop normalizing the use of narcotic pain medications.

Those are for extremely acute use (e.g. surgery) or for terminal cases.

Edit: is this being taken over by the sackler family shills or what? Why is what I’m saying at all controversial?

Narcotics are for a matter of hours or days. Unless they’re palliative.

Drusas ,

As someone who was just in the ER with 9 to 10 out of 10 pain, you are totally incorrect. Sometimes you have extreme pain without surgery or impending death. Non-opioids don't even touch that level of pain.

PetDinosaurs , (edited )

What was/is causing your pain?

Unless you were stabbed or shot or had appendicitis or pancreatitis or kidney stones or something (all of which qualify as acute to me and are suitable for a short course of narcotics), pain that severe is typically caused by inflammation of the nerves as they leave the spine. Or cancer.

Nerve pain is best treated with steroids, not narcotics.

I’ve been there. It was, by a huge margin, the worst pain I’ve ever experienced. My arms and shoulders hurt so much that I couldn’t do anything but think about the pain. The problem wasn’t in my arms. It was in my neck.

I didn’t know what a 10/10 was until then. All my other pain (even various surgeries) were just 5/10 compared to that.

Edit: I can’t even imagine why this is controversial. Please answer the most important question. Where did the pain come from?

Drusas ,

I had an adverse reaction to an iron infusion. They were not able to figure out the specific cause of the pain, but morphine sure helped me get through it.

PetDinosaurs ,

And this is something that people think it’s contradictory to what I’ve said?

Narcotics managing acute pain is fine. Narcotics are only for that.

Drusas ,

Your initial comment made it sound as though you support it being much more restricted.

PetDinosaurs ,

Narcotic medications should be far more restricted than they are.

That’s the point.

Drusas ,

My experience in the past few years is that they are already extremely restricted. I had a fairly major surgery after which I was not given narcotics, and in hindsight, I would have demanded them, because whatever they did give me did not work.

PetDinosaurs ,

When you have surgery, you’re supposed to have pain.

It’s always been a tradeoff, and that’s something that lay people seem to have no understanding of. Do I suffer with my problem or treat it?

The fact that people are demanding pain free medical experiences is the problem.

There are no tools that deliver pain free surgery. The closest thing that humans can currently do is drug you out. That’s the problem. Pain and pleasure are so primal, that they’re probably isn’t any way to separate them. Even in principle.

I got offered way more drugs than I needed or wanted in every (more than office visit) surgery I’ve ever had.

Drusas ,

There is nothing wrong with giving somebody a week's worth of narcotics to help them recover from surgery. It takes more than a week to become addicted.

PetDinosaurs ,

For certain people, a single self administered dose is all it takes. That’s not the point though.

I absolutely said that narcotics for acute surgical pain are ok.

However, if you got a whole week of narcotics for outpatient surgery, your physician is part of the problem.

Fades ,

Try passing a kidney stone without opioids

PetDinosaurs ,

I literally stated this as an example of an acute and appropriate use of opiates.

Drusas , (edited )

I think that you think your initial comment was more encompassing of acute conditions than it came across as being.

Subverb ,

Four years ago I was hospitalized on and off with pancreatitis. Without dilaudid I literally was crying and writhing in pain.

Maybe speak for yourself instead of everyone.

PetDinosaurs , (edited )

So you would be a candidate. Exactly like I said. Pancreatitis is pretty acute and is listed in another post of mine.

afraid_of_zombies ,

When a machine fell and crushed my hand a while back they wouldn’t give me anything for the pain besides OTC. Broken finger bone and bruises and all I got is Tylenol. That was one of the worst nights of my life. Crying bent over with pain begging them on the phone for anything. I get migraines on occasion and that was worse.

My wife suggested cannabis so I went to a dispensary. Never had the stuff before and oh man did it work wonders. Under 15 minutes. If it hadn’t been legal at that time I would definitely gone to the nearest bad neighborhood and try to buy something. Which of course could have gone seriously wrong for me.

Maybe don’t tell other people how much pain they can endure.

PetDinosaurs ,

What does any of this have to do with anything I have ever said?

pinkdrunkenelephants ,

Your dumb ass said, in regards to narcotic painkillers:

Those are for extremely acute use (e.g. surgery) or for terminal cases.

Narcotics are for a matter of hours or days. Unless they’re palliative.

Which is not how reality works, at all.

Our friend gave us a very personal example as to why.

It literally doesn’t matter if they’re addictive or not, normal people need narcotics for severe pain and it’s unethical to deny them to curb addiction numbers.

Potatos_are_not_friends ,

Study 1 documented these beliefs among white laypersons and revealed that participants who more strongly endorsed false beliefs about biological differences reported lower pain ratings for a black (vs. white) target.

Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs.

Moreover, participants who endorsed these beliefs rated the black (vs. white) patient’s pain as lower and made less accurate treatment recommendations.

This paper is from 2016. That’s 7 years ago.

www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/

We need boomer doctors to die out already. And to fix medical education.

ThePantser ,
@ThePantser@lemmy.world avatar

This is one battle we should be going the other way, let’s give less opioids to all.

jeffw OP ,

From the data, it is trending down overall

givesomefucks ,

It’s slowly getting better, but medical care is lagging because doctors are way more likely to be old.

It’s “implicit bias along ingroup”.

Those old white doctors never grew up socializing or even really seeing Black people as toddlers.

So they’re not good at reading emotion (in this case pain) in Black people.

Low melanin makes everything easier. Pupil dilation, blushing reaction, all these things we look at on a subconscious level to understand what another person is going through is just more visible with less melanin. So if you only grow up with low melanin people, you’re never going to learn to look deeper.

We can use conscious thinking to combat that, but as you age and lose critical thinking, the problem gets worse again. So a 65 year old white doctor just isn’t capable anymore of doing that. Rather than understand the science behind it, they double down and say if they don’t think a patient is really in pain, they’re lying to get pills.

It’s like how when surgeons were told to wash their hands for their patients health, more stopped washing their hands than started. The medical community even got the doctor who publicized washing their hands committed to an insane asylum.

Elderly people usually respond with aggression when their knowledge or skill is questioned, which ironically is another sign of the age related mental decline they claim isn’t happening to them…

ChrisLicht ,

It’s wild how slow the medical profession is to adopt core changes in technology. You still see paper files, fax machines, resistance to email; outright allergy to SMS, shitty web portals, phone systems that take ten minutes to navigate, dictaphones.

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