The poor white suffer the consequences of the opioid crisis in the United States

MONDAY, Feb. 11, 2019 (HealthDay News) – The opioid epidemic that plagues America has hit poor whites harder than any other group, and a new study says that racism probably played a role in that evolution.

Whites have better access to prescription drugs than blacks or Hispanics. This privilege may be due to their loss when doctors started treating pain more aggressively with prescription opioids, said lead author of the study, Joseph Friedman. He is a medical student at the Faculty of Medicine at the University of California at Los Angeles.

A study of prescribing habits in California found that doctors were distributing potentially addictive drugs – opioids, stimulants and benzodiazepines – to whites at higher rates than minority groups.

"We propose to view the prescription drug crisis as a" double-sided "epidemic in which systematic racism within the health system has led to increased dependence and overdoses in low-income white areas, but also to insufficient treatment among non-whites, "said Friedman.

"These disparities may have ironically protected communities of color from the shock of the opioid epidemic," Friedman continued. "Nevertheless, they also represent a lack of access to adequate treatment for pain and psychiatric problems."

Friedman's research is part of a set of studies on the opioid epidemic that will be released Feb. 11 JAMA Internal Medicine.

In addition, a New York-based study revealed the existence of two opioid overdose epidemics taking place side by side: one involving poor whites, young and middle-aged , became addicted to opioids through prescription medications, and another involving middle-aged and older people. older blacks and Hispanics who have long used street narcotics such as heroin.

A study by the US Centers for Disease Control and Prevention found that stricter regulations have reduced the number of opioid prescriptions in the United States, but drugs are still prescribed at almost three times the rate to that of 1999.

"We still have a lot of opioid prescriptions underway," said Lindsey Vuolo, badistant director of law and health policy at the Center for Addiction. Vuolo was not involved in the research.

For their study, Friedman and his colleagues collected records of 29.7 million people who received a prescription for a controlled substance in California between 2011 and 2015.

The postal codes badociated with each prescription allowed researchers to evaluate the order patterns in specific neighborhoods, based on the racial makeup and average income of each community.

They found that there was a big difference in opioid prescribing habits when race and income were taken into account.

For example, about 44% of people living in predominantly white slums received at least one opioid prescription per year, compared to about 20% of those living in predominantly minority slums.

This trend continued even as income levels increased.

These poor white neighborhoods also recorded more opioid overdose deaths than any other – 9.6 per 100,000, compared with 3.7 out of 100 for poor and predominantly non-white neighborhoods.

"The sub-prescription of opioids to non-white communities could have been a protective factor in reducing the number of opioid overdose deaths in these communities," Vuolo said.

The trend has also been maintained for other controlled substances, including benzodiazepines (drugs such as Valium and Xanax) and stimulants (drugs such as Ritalin or Concerta). Whites always had better access to these ordinances than blacks.

In fact, high-income, predominantly white neighborhoods were more likely than any other community to receive stimulant prescriptions, Vuolo said.

"It 's really worrisome, because if high opioid prescribing rates preceded the opioid epidemic, high rates of stimulant prescribing could really be a sign of". an epidemic of stimulants, "said Vuolo. "We are already seeing an increase in the use of methamphetamine and cocaine and a number of overdose deaths."

The researchers found that stimulant prescriptions were more common in boys aged 10 to 14, suggesting that drugs are most often prescribed for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). (ADHD).

The CDC study found that opioid prescription rates have declined at an accelerated rate since 2012, thanks to new stringent regulations.

The amount of prescribed opioids has decreased by an average of 10% per year, with reductions in three out of four US counties between 2015 and 2017.

In comparison, opioid prescriptions only decreased by 3.6% per year between 2010 and 2015, with reductions in only half of the counties in the country.

Nevertheless, the CDC found that the duration of opioid prescriptions continued to increase.

More information

The US Centers for Disease Control and Prevention have more on the opioid epidemic.