HealthDay News — Racial disparities exist in opioid monitoring and follow-up treatment practices among patients receiving opioids for noncancer pain, study findings suggest.

Black patients were less likely to be referred to a pain specialist and more likely to be referred for substance abuse, Leslie R.M. Hausmann, PhD, from the University of Pittsburgh, and colleagues reported in Pain.

Black and Hispanic patients are less likely to be prescribed opioid medications for severe pain, previous studies have documented, but little is known about whether and how race affects follow-up care among patients receiving these types of medications.

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So Hausmann and colleagues analyzed electronic health record data from a cohort of 1,646 white and 253 black patients who filled opioid prescriptions for 90 or more consecutive days at the Veterans Affairs Healthcare System pharmacy in Pittsburgh from 2007 to 2008.

During a 12-month follow-up period, 71.7% of patients had pain symptoms recorded during primary care visits, 49.3% underwent urine drug testing, and 26.3% had documented opioid agreements on file. 

Overall, 21.2% of patients were referred to pain specialists, whereas 4.2% were referred to substance abuse specialists.

In adjusted comparisons, black patients had pain recorded less frequently at follow-up, were less likely to be referred to a pain specialist, and more likely to be referred for substance abuse assessment compared with white patients. Among patients who had at least one urine drug test, black patients — especially those on higher doses of opioids — were subjected to more urine tests than white patients. 

“Addressing disparities in opioid monitoring practices may be a previously neglected route to reducing racial disparities in pain management,” the researchers wrote.


  1. Hausmann LRM et al. Pain. 2013; 154(1):46-52.