Jordan M. Harrison is with the University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, and the University of Pennsylvania Perelman School of Medicine, National Clinical Scholars Program, Philadelphia. Pooja Lagisetty is with the University of Michigan Medical School, Department of Internal Medicine, Ann Arbor, and is also with the VA Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor. Brian D. Sites is with the Department of Anesthesiology, Geisel School of Medicine at Dartmouth, Hanover, NH. Cui Guo is with University of Michigan School of Public Health, Biostatistics Graduate Program, Ann Arbor. Matthew A. Davis is with the University of Michigan School of Nursing, Ann Arbor, and the University of Michigan Institute for Social Research, Ann Arbor.
Am J Public Health. 2018 Jun;108(6):788-790. doi: 10.2105/AJPH.2018.304349. Epub 2018 Apr 19.
To examine national trends in the use of various pharmacological pain medication classes by race/ethnicity among the US pain population.
We used data from the Medical Expenditure Panel Survey to conduct a nationally representative, serial cross-sectional study of the noninstitutionalized US adult population from 2000 to 2015. We identified adults with moderate or severe self-reported pain and excluded individuals with cancer. We used complex survey design to provide national estimates of the percentage of adults with noncancer pain who received prescription pain medications among 4 groups: non-Hispanic White, non-Hispanic Black, Hispanic or Latino, and other.
The age- and gender-adjusted percentage of prescription opioid use increased across all groups, with the greatest increase among non-Hispanic White individuals. By 2015, the percentage of non-Hispanic Black adults using opioids approximated that of non-Hispanic White adults-in 2015, approximately 23% of adults in these 2 groups used opioids.
To our knowledge, this is the first evidence of a narrowing divide in opioid prescribing by race. However, in the context of the national epidemic of opioid-related addiction and mortality, opioid-related risks do not appear commensurate with the purported benefits.
考察美国疼痛人群中不同种族/族裔使用各种药理类止痛药的全国趋势。
我们使用医疗支出调查数据，对 2000 年至 2015 年期间非住院的美国成年人口进行了全国代表性的连续横断面研究。我们确定了有中度或重度自我报告疼痛的成年人，并排除了患有癌症的个体。我们使用复杂的调查设计，在 4 个群体中提供了有非癌症疼痛的成年人接受处方止痛药的百分比的全国估计数：非西班牙裔白人、非西班牙裔黑人、西班牙裔或拉丁裔，以及其他。
在所有群体中，年龄和性别调整后的阿片类药物使用率都有所增加，其中非西班牙裔白人的增幅最大。到 2015 年，使用阿片类药物的非西班牙裔黑人成年人的比例已接近非西班牙裔白人成年人-在 2015 年，这两个群体中约有 23％的成年人使用阿片类药物。
据我们所知，这是首次有证据表明种族间阿片类药物处方的差距正在缩小。然而，在全国阿片类药物相关成瘾和死亡的流行背景下，阿片类药物相关风险似乎与所谓的益处不成比例。
