Those minors will take whatever we dish out! - bushism

Why bother with these studies? Final study: If you're white, all your actions are nothing but pure racism.

I'd like to see this broken down by income level as opposed to race, because I think the most likely explanation is rich people buying prescription drugs for recreational use.

This isn't surprising given that there's always some report about how women and/or minorities are more likely to die of X.

For example, this article (a few years old): [www.americanheart.org]

I think there is truth in this study. I mean minorities are use to dealing with pain and such... usually caused by the white man!

OH SNAP.

It's only payback. White America introduced crack to minority neighborhoods and created a new batch of addicts. Now White America is trying to hook their own folk onto a more expensive habit.

Can we just agree that rich White people aren't doing any good for anybody?

/wishes he was rich
//already White

In my experience, with EMTs and Trauma Staff at two Iowa hospitals, no one is ever refused pain medication. Hospitals in Iowa will dole out the pain meds if you show any discomfort. Now, whether they give you extra strength Tylenol versus Tylenol-3 (with codeine) depends on your diagnosis. But here in the midwest I don't think that race has anything to do with it.

I also know that this fact is readily abused by many ER patients.

UM, I am going to ask the most obvious question here.

What was the racial make up of the people of the people providing the painkillers?

And then, how does it match up to the make up of the patients?

Also with one race treatment to someone of the same race, does the care provided change? I.e. Black doctor to black patient, to white patient, etc?

Without more data, this whole thing is crap that could be dismissed by simple geography (i.e. expensive hospital in the burbs versus an overwhelmed hospital near the projects).

This was a shortcut study designed to get an answer that was wanted, instead of giving more data and information to form conclusions, and even, come up with solutions.

Oh brother this is pathetic.

Of course the White Conservative Male is always wrong (unless its the Jews, right?)

Well the Conservative Black Male is also wrong in the media's eyes.

Has anyone looked at average wages, unless you have done alot of work in black neighborhoods you will never understand the ethic. The idea in most black/hispanic ghettos is take as much as the government will give you, in the meantime try not to give any back, because the only people benefitting will be the white people.

I have done lots of work in poor neighborhoods, I understand the mentality to say that the White people are guilty for everything wrong with minorities is absolutely ludicrous. There were certainly problems with the systemic repression of Blacks until about 1985, now, its ethic.

So is the claim that minorities are being denied painkillers or merely that they're not being prescribed them? Where does the blame lie exactly?

I agree that this study should be looked at in a socioeconomic sense, not a racial one.
I work in health care and I think one of the biggest differences is how different races express pain and their idea of acceptable pain.
EX: We've got two expectant mothers in the same room. One is of Italian descent and the other is of Asian descent. The Italian is very expressive and the whole floor knows when she has a contraction. The Asian is very reserved and silent.
Guess which one started to deliver and caught us by surprise?

If you are in pain, sometimes you need to be a squeaky wheel.

No one else is gonna say it?

Fine.

It's "opioid," Chris.

This would mean something if they concluded something about the way that minorities use the American Health Care System (they're statistically less likely to have health insurance and a Primary Care Physician because of that and more likely to use the emergency room in lieu of seeking the care of PCP.)

It could also be because when you're uninsured you're less likely to demand palliatives-I certainly didn't demand possibly expensive prescriptions when I didn't have health insurance.

The assertive hypothesis sounds plausible however there doesn't seem to be enough data to really tell us why. I think there should have been more research done before making a report.

Save them poppy seeds.

@youbastid: I was gonna say it, but was thinking maybe it was an annoucenment of Apple's new foray into dyslexic Irish medical audio devices.

But "opioid" is good too.

And, I've got a new Scrabble word.

This also need to broken down not by amount of pain, but reason they are in the emergency room. Different races have different health trends, and it may be in part that white people are coming in with different types of injuries that are more likely to use opiates to treat them.

If I come in with a bad sore throat, I'm prescribed codeine. If I come in with a headache (which hurts more) I'll walk out with two Asprin or possibly some Ibuprofen.

You really need to know a lot about this study for it to be valid.

Were the patients complaining of the same symptoms and expressing their pain in the same way?

Were the same injuries being compared in the same physical locations?

Who had insurance and who didn't? Were doctors being racist or simply prescribing cheaper, non-opioid, pain medicines to people who had to pay more out of pocket?

@canerican: Really? So recent case studies that show that in numerous geographic areas otherwise identical White Males with a Criminal Record are hired more often than Black Males with no Criminal Record (and that Black Males with a Criminal Record are rarely hired at all) are just lots o' coincidence?

And continued case studies showing that otherwise identical minorities are still rented apartments less often than their white counterparts are just fictitious even in liberal urban centers?

I too have spent plenty of time working in "poor neighborhoods" and disagree wholeheartedly with your anecdotal perspective not only based on the studies, but from my own experiences as well.

@pigeonpenelope:

Your absolutely right, I would also add, I would love to see the methodology, i.e how was this done, how many african americans, how many asians, how many whites, and also where or what type of locations was this study done at?

I.E. Hospital in suburbs, in the inner city, etc.

I can statistically prove that the sky is orange. And yet it still tells us nothing, just like this report.

But on the other hand, are the non-whites getting other classes of pain killers more?

@canerican: Lots of comments like this one.

Among some MD's, the perception is: Urban/Minority=Diversion and or abuse.

This is especially true in New York since July 1st 2007. This date was the start of electronic transmission of Narcotic prescription reporting. Basically, whenever a health care practitioner writes an RX for anything narcotic, it is electronically transmitted to Albany for review(other States have laws like this also). The law was intended to reduce diversion and abuse.

July 2007 was also the beginning of a trend seen by myself and many colleagues where upon Hospital discharge, Patients were deemed magically cured of pain symptoms. Prescriptions for Narcotics among this observed group (minority/urban/recent inpatient discharge) virtually disappeared. I can also tell you that these were painful diagnoses(osteomyelitis, Bone fractures, bacterial pneumonia etc.) which had been treated with heavy doses of narcotics up until the day of discharge.

In reality though, pain management has taken about 10 steps backwards. The people who are prone to substance abuse still end up doing so. The people who require pain management are hyper scrutinized and often times denied effective treatments.

The Bush justice department's targeted jailing of pain management MD's has not inspired compassion among those treating chronic or even acute pain.

Sad.

Scientific American is a political magazine masquerading as a science magazine. I believe exactly zero of what they publish. It's a shame too, they used to be my favorite magazine.

I don't think this has anything to do with racism, I think the researcher hit it on the nose. This is about many minorities inability to articulate their symptoms as well. It is also a measure of many minority's assertiveness and sense of entitlement. It's a cultural thing, many of the older people in my family (Puerto Rican) are used to mistrusting doctors and usually want to get out of a hospital of office as quickly at possible. If anything the study is placing the "blame" on the minority.

@lincolnparadox: That's part of what's being said. Given the same pain level, if you are a minority, you are more likely to get prescribed strong over the counter meds (Ibu 800mg, Aspirin 1000mg, etc) instead of controlled meds (Morphine, Codine, Oxy).

Better Article:
[www.startribune.com]
//The irony, she said, is that blacks are the least likely group to abuse prescription drugs. Hispanics are becoming as likely as whites to abuse prescription opioids and stimulants, according to her research. She was not involved in the current study.//

//Patient behavior may play a role, Pletcher said. Minority patients "may be less likely to keep complaining about their pain or feel they deserve good pain control," he said.//

What that last one is saying is that minorities suck it up/walk it off while whities bitch and moan about every little last pain. Which if you look at it, is true.

@cde:

That article is a AP writeup of the information. And is more informative.

Oh god I'm going to have to bite my tongue on this one. Just bite your tongue and walk away...

1) There are no obvious conclusions or implications of this article. White people get more painkillers...maybe they have more pain. Does this include pregnant women? Most of them want painkillers on arrival.

2) In a country with so much cultural diversity, why didn't the scientists look at how culture comes into play? We are obviously talking about a majority of American-born white and black people, yet a majority of Hispanics and Asians most likely were not born in the U.S. I know that the older generations of Asian people are more distrusting of Americans or white people, not necessarily because of race, but because they are transplants to another country and there is a significant language barrier for a lot of them, more so than for Hispanics.

Really, just check out Chinatown. There are stores upon stores selling herbal remedies and roots of various kinds promising health benefits. Is it any wonder that a lot of Asian people who have been raised in Asia are suspect of Western medicine and perhaps may be less inclined to trust in it? When my grandfather got sick, heck yes we took him to the hospital. But I doubt he would've gone if it were just up to him. After every hospital visit, my grandma would whip up a batch of some herbal remedy, and he'd have that along with all of his doctor-prescribed medicines. I don't know if it did any good, but when I was a kid, my mother would treat my coughs and sniffles with robitussin and some herbal drink, because her mom had done it, and whether it was actually helpful or not (I doubted it), it was what was taught.

@boberto: In reality though, pain management has taken about 10 steps backwards... The people who require pain management are hyper scrutinized and often times denied effective treatments.

So True. I deal with chronic foot/leg pain from an injury 10 years ago. And while I barely use (by choice) narcotic pain meds, I have had 2 calls from the state regulators concerning the "frequency" that I fill a particular med. I guess 2 prescriptions of Dilaudid over a 10 year period is suspect. But no thanks on the big stuff. Just give me good ol Tylenol #3 and life is just grand.

@B: Because surely wealthy people have no better recourse for getting narcotics than the local public emergency room. =P

There are too many missing factors. Gender of the doctor vs. the patient should be studied. There are some male doctors who will dismiss medical complaints by female patients. There are cultural differences vs. the doctor. If the doctor isn't interpreting what the patient is telling them correctly they may think the patient is fine or totally over-reacting when that is not the case.

Income and insurance should also be looked at. I know when I was in the hospital with extremely good insurance the staff was trying to milk the insurance for all it was worth. They kept offering me extra services I really didn't want or need. This was the polar opposite of when I was in the hospital with crappy bare bones insurance.

The concerns about patients abusing or diverting medications goes beyond race stereotypes. There have been ongoing issues in poor white rural areas of people selling their medications in the exact same manner that has been labeled a minority/urban problem.

@canerican: You do realize that your comment has absolutely nothing to do with the article, right?

I'll say this much at least...I agree with all of you saying that there are too many missing factors, and I believe it should have been done by culture/nationality group rather than skin color. Example being, there are a lot of people who fall under the 'Hispanic/Latino' tag but are from widely varying tribal groups and locations. The same goes for White, Black, Asian, etc. I also agree with the gender factor, not only are male doctors more likely to dismiss complaints by female patients, but female patients may feel uncomfortable voicing their symptoms to someone of the opposite gender, and vice versa.

Opiates are the more hard-core natural-based addictive meds (like Vicodin, Oxycodone, Percocet, etc), Opioids, also pain meds, but synthetic versions, and less likely to have the user form addictions (Tramadol, for example).

Why is this study so hard to believe? Most hospitals keep meticulous records for legal reasons. Its not a subjective survey. Blacks and other minorities were either prescribed the drugs or not. Not that this validates the article but I first hand experience two weeks ago. My wife and I were out of town visiting family. She began having severe abdominal pain. One ER provided minimal service and accused of doctor shopping when the Dilaudid dose failed to alleviate the pain. Of course we left after we raised a stink and they threatened to call the police. I was able to GPS another ER 15 miles away. Similar testing performed and this hospital was able to locate a badly infected cyst in one of the fallopian tubes. Potentially fatal condition had it burst. Yes, I had insurance. Yes, I am keeping my legal options open but since her life was saved there are really no damages to pursue.

This African American has no reason to doubt this article.

Maybe minorities don't complain as much about pain as white folks. Just a thought.

The fear on the part of doctors that they might get in trouble and heightened suspicion of patients isn't helping matters. You can start getting some wacked out results when doctors start making snap judgements about people and their potential to be trying to obtain narcotics for misuse.

There has been some evidence of some doctors refusing to prescribe pain meds to patients with tattoos under the assumption that someone with a tattoos is more likely to abuse or sell drugs. If those kinds of random judgements are being made, race judgments are certainly not a stretch either. I still think the unequal care has more factors at play than just race.

Just keep my ass alive and don't worry about getting me addicted to the latest goddamned designer drug.

Blowfish- The article states number but provides no meaning or context.

It doesn't state if the patient complain more thus receive medicine. It doesn't mention if like conditions were compared.

It also doesn't look to see if Whites and Asians are being over prescribed the medications.

Your wife didn't need pain killers she needed a better diagnosis. I am glad that you were clear headed enough to find another hospital and get her help.

@Blowfish:

Actually, you just gave a very valid reason to doubt this article.

One hospital would not serve you properly, while another one did.

What isn't explained here, is where the hospitals were located for this study.

Thanks Sonnymooks!

Also I wonder if doctors don't prescribe pain killers to those they know have medical insurance. In this case, it is a matter of the insured and the uninsured. It can be possible that folks of certain minorities are not with medical insurance due to socio-economic reasons.

Ugh. Too many possibilities.

@WTRickman:

I highly doubt that african americans are meek and submissive when in pain, just another thought.

Bohemian: I think you also have a good point.

@Sonnymooks:

Good point.

It has more to do with percieved economic factors than color of skin.

Most black people are poor, so the stereotype goes, if you are poor and need a fix you go to the ER. Doctors don't want to feed your fix.

Most white people are rich, so the stereotype goes, if you are rich and need a fix you call your dealer or your own doctor.

If you think of the economic stereotypes wealth goes 1)Whites 2)Asian 3)Hispanic 4)Black.

Some of you are complaining that the article doesn't look at some obvious demographic explanations. Well, the Scientific American summary doesn't show the whole story, but this is from a study published in the Journal of the American Medical Association.

Like they would for any serious, scholarly study, the researchers coded the cases for any obvious alternative explanations and included them in the analysis. I went and looked at the study description in JAMA and here are some of the factors they also analyzed: patient description of pain, doctor diagnosis, patient characteristics such as whether they had a chronic condition or were an alcoholic or drug user, age, gender, whether they had insurance, hospital characteristics such as urban or rural, hospital region, hospital regional type.

These alternative explanations for the difference are included in the model-- if the race explanation is too strongly correlated with one of the other factors it would not be statistically significant. But even with all these factors included, the different treatment for minorities holds up.

@LadyCarolineLamb: Ultram/Tramadol is non narcotic, non opioid. It is an opiate agonist, and inhibits reuptake of seratonin and norepinephrine.

So the main point here is ?????? We're not giving minorities enough addictive pain medication?? On top of the non-existent point of the article, the percentages aren't very lopsided anyway. And as long as we're picking apart typos: watch out for those "hisanics."