Also see our section on PAIN under Studies (left side of any page). Only one in four pharmacies in minority neighborhoods in New York City carry an adequate supply of medications commonly prescribed for severe pain, according to results of a new study. In contrast, almost three-quarters of pharmacies in predominately white neighborhoods have the drugs in stock, researchers report. Based on experience with patients -- predominately African Americans and Hispanics -- who had trouble filling prescriptions for pain-killing drugs called opioid analgesics, Dr. R. Sean Morrison and colleagues at Mount Sinai School of Medicine in New York, decided to investigate whether most pharmacies carried medications strong enough to treat severe pain. ``We had a suspicion that there were inadequate supplies in all the pharmacies,'' Morrison told Reuters Health in an interview. The researchers surveyed 347 pharmacies in New York City and found that 51% of them did not carry enough of the painkillers for the adequate relief of severe pain. The odds of being able to fill a prescription for pain medication were much lower in minority neighborhoods, according to the report in the April 6th issue of The New England Journal of Medicine. Just 25% of pharmacies in predominately minority neighborhoods -- where less than 40% of residents were white -- had adequate stocks of pain medication, compared with 72% of stores in neighborhoods where at least 80% of the residents were white. When asked why they did not stock a full supply of the medications, many pharmacists said that they feared theft, that there was a low demand for the drugs, and that the regulations on the drugs were too burdensome. In interviews, many also said that the paperwork required by state and federal regulatory agencies was a major disincentive for keeping a supply of opioids. ``My patients have become victims of the war on drugs,'' Morrison told Reuters Health. He said it is time to reevaluate federal regulations that govern opioid analgesics, since they are ``serving as barriers to pain management and high quality medical care.'' In an editorial accompanying the study, Dr. Harold P. Freeman of North General Hospital, and Dr. Richard Payne of Memorial Sloan-Kettering Cancer Center, both in New York, state that racial bias, often unintentional, plays a role in the inadequate supply of the opioid pain-killers. Part of the reason for the low demand cited by pharmacists may be that physicians are underprescribing opioid analgesics for minority patients, they suggest. Freeman and Payne call for campaigns aimed at raising awareness about racial issues among physicians and other medical professionals. ``Physicians, as well as pharmacists, police officers, and others, must learn to see people not through the lens of race but instead as the individual persons they are,'' they conclude. Morrison agreed that racism could lead to inadequate pain management. Minority patients in severe pain are stuck in ``a terribly vicious cycle,'' he said. They are less likely to have their pain evaluated by a physician and are less likely to get prescriptions for pain medications, and even when they do, their pharmacies are unlikely to carry the medications. SOURCE: The New England Journal of Medicine 2000;342:1023-1026, 1045-1047. By Merritt McKinney, Reuters Health April 5, 2000 From the Texas Cancer Pain Initiative,6/00 J General Internal Medicine 4/01 Underestimated in some communities, study in Cancer (journal) 4/00 Pain And Perceived Needs/Barriers Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.