Study: Trends in Prescription Opioid Abuse Reflect Racial Disparities

Author: Lauren McGrew-Hitzhusen

What causes prescription opioid abuse?

In the late 1990s, opioids became the go-to solution for pain treatment. Prescription numbers soared.

But…they didn’t soar evenly. The stats flew higher for some populations.

Researchers at NYU School of Global Public Health have looked at the numbers. They discovered that “people of color were less likely to be prescribed opioids in the late 1990s.”

Considering how things turned out for those who were over-prescribed, this might be a good thing. But it still raises an interesting question: Why?

Why did people of color receive fewer opioid prescriptions when these first became available? Is this an indication of under-treatment?

The researchers made another interesting find. This disparity doesn’t carry over to opioid use in later years.

By the mid-2000s, “prescription opioid use among Black individuals matched that of whites.”

So, what does this say about prescription opioid abuse?

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A Look at the Numbers

For this study, researchers looked at prescription opioid use among 250,596 US adults between 1996 and 2017. The researchers’ analysis revealed that prescriptions among Black, Hispanic, and white adults differed at the beginning of this timeframe. At that time,  whites used more opioids than the other two groups.

Check out the opioid use numbers from 1996:

• Whites: 11.9 percent
• Blacks: 9.3 percent
• Hispanics: 9.6 percent

But, by the early 2000s, things changed. Prescription opioid use continued to grow. It was prevalent among all three races.

By the mid-2000s, the numbers show that “prescription opioid use was as prevalent among Blacks as whites, and remained that way through 2017.”

The Rise and Fall of Opioid Prescriptions

Prior to the 1990s, opioids were commonly used for pain management after surgery. And to treat pain in cancer patients. But the late 90s saw:

• Aggressive marketing by pharmaceutical companies
• Widespread campaigns for pain management
• Lax prescribing laws

And by 2004, prescription opioids had taken the top slot among pain management drugs.

We knew we were in trouble in the middle of this rise. The opioid epidemic had spread through the nation. Officials realized something needed to change.

In the 2010s, prescribing limits were adopted. This led to a decline in prescription opioid use among Blacks, Hispanics, and whites. But by then, many people were already addicted.

And when they could no longer get prescription pills, they turned to illicit options, like heroin, to feed their addictions.

This entire cycle, we now realize, led to a rise in overdoses that continues to this day. During the 12-month period from April 2020 to April 2021, there were more than 100,000 drug overdose deaths in the United States.

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Illicit Versus Prescription Opioid Abuse

Did the difference in prescription numbers affect addiction rates, illicit drug use, and overdose numbers? It’s hard to tell. Virginia Chang, associate professor at NYU School of Global Public Health made an interesting point:

“Media coverage of opioid use often differs by race and ethnicity, where prescription opioid misuse is portrayed to primarily affect whites, and illicit opioids are associated with people of color. However, Blacks were as likely as whites to use prescription opioids in the mid-2000s and 2010s, suggesting that they may also be at increased risk for prescription misuse.”

Looking at prescription opioid use among Hispanics may shed some light on the subject. During the 2000s and 2010s, prescription opioid abuse among Hispanics remained lower than use among whites and Blacks. And the Hispanic population has experienced fewer overdose deaths than Blacks or whites.

Good News or Bad?

While fewer overdoses is a good thing, the disparity in opioid prescriptions could prove to be a negative. Other research has also shown that Hispanics are less likely to receive opioids than whites or Blacks.

And the NYU study shows that Blacks and Hispanics received fewer opioid prescriptions at the outset than whites.

This could indicate under-treatment of the Black and Hispanic populations. When the drugs first entered the market, why were they prescribed more to whites? This study didn’t cover the reasons, only the prescription numbers.

Chang notes, “In the late 90s, doctors weren’t prescribing opioids to people of color with the same frequency that they were prescribing them to their white patients. While this study doesn’t measure whether these disparities stem from prescribing practices, patient preferences, or another reason, prior research shows that underrepresented racial groups are less likely to be given new prescription medications.”

Prescription opioid abuse is a major problem in our country, no matter the race.

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