The OxyContin problem: how racism can have positive effects

[warpus]

Prescription drug addiction is a huge problem, and ironically enough the so called "War on Drugs" is not touching the problem with a 10 foot pole.

I don't see any racism anywhere here though, sorry.

 

[Samson]

I don't see any racism anywhere here though, sorry.

What is observed is that the rates of perscription, addiction and overdose of OxyContin is very high in poor white women, and much lower in the otherwise similar demographics of African-American or Latino women.

The reason for this is postulated by Dr Andrew Kolodny to be that the doctors suspect their African-American or Latino patients will abuse or sell the drug, and so are much less likely to perscribe it.

 

[GoodEnoughForMe]

The entire hypothesis of addiction being a case of doctors only prescribing for white people is kind of off, because the vast majority of opioid addiction is not started via prescription, but by illegal sharing/dealing of the drugs. Most addictions start out in adolescent years and addicts typically use and abuse other drugs and alcohol. I guess we can say it's easier to deal when we're prescribing so heavily, but there are tons of cases of legitimate use for painkillers.

The opioid addiction is a failure of mental health treatment and economic support. There are a grand total of 3 psychiatrists in the entire state of Indiana that are specialized to treat addiction. Three.

 

[warpus]

The reason for this is postulated by Dr Andrew Kolodny to be that the doctors suspect their African-American or Latino patients will abuse or sell the drug, and so are much less likely to perscribe it.

I don't buy that, mainly because they must see how addicted to this stuff the people they do prescribe it to get. But if there's been studies done on this and hard data exists, l would love to see it.

 

[emzie]

I don't buy that, mainly because they must see how addicted to this stuff the people they do prescribe it to get. But if there's been studies done on this and hard data exists, l would love to see it.

The implication is black people were less likely to be prescribed OxyContin than white people because of a bias in doctors.

Approximately 85% of treatment-seeking patients approached to complete the Survey of Key Informants’ Patients Program did so. Respondents who began using heroin in the 1960s were predominantly young men (82.8%; mean age, 16.5 years) whose first opioid of abuse was heroin (80%). However, more recent users were older (mean age, 22.9 years) men and women living in less urban areas (75.2%) who were introduced to opioids through prescription drugs (75.0%). Whites and nonwhites were equally represented in those initiating use prior to the 1980s, but nearly 90% of respondents who began use in the last decade were white.

http://www.ncbi.nlm.nih.gov/pubmed/24871348

 

[Farm Boy]

I think we're misdiagnosing the source of the problem. White people can get their heroinish legallyish more easily. If you eliminate the legal access part it will swing back to illegal access. Pain is not the only hole which opioids are filling.

 

[warpus]

Looking at the data, I don't see causation inherent in it, just the outcome. But maybe I'm in denial and refuse to believe that the majority of doctors in the U.S. are racist.

 

[emzie]

Looking at the data, I don't see causation inherent in it, just the outcome. But maybe I'm in denial and refuse to believe that the majority of doctors in the U.S. are racist.

I'd like it if bias became more commonly used. I think you can be biased, often out of ignorance, and still cause harm without actually holding enough biases to make you a racist. For a long time drug use has been thought of as a minority thing (even though white people do more drugs). It's plausible that doctors might be more hesitant to prescribe painkillers to black patients because of the mistaken belief that blacks are more likely to abuse drugs. Or, perhaps, the lack of cultural interaction between white doctors and black patients makes it harder for doctors to empathize with their patient and they're less likely to believe the severity of reported pain.

 

[Narz]

Drug laws are so disgusting. I don't even like weed but it overperforms opiates on painkilling without any lethal side effects ever & yet it's illegal while this crap is legal & being served up to the most vulnerable everyday.

The scheduling of drugs in American is about as scientific as bloodletting and phrenology.

 

[Ryika]

The implication is black people were less likely to be prescribed OxyContin than white people because of a bias in doctors.

Well, the implication of women earning 77c for every Dollar a man earns is that bosses are biased against women.

Of course, if you look closer into it and check for other factors, such as job preference, hours worked, etc. - or directly compare men and women in very comparable positions, with a very comparable history - the wage gap closes for the most part, leaving only a few percent for biases against women and other factors that can't be checked for.

That's why I'm curious when I see a statistic like this.

At first glance it seems to indeed imply that doctors would prescribe these drugs differently because of bias, but the idea that a large majority of doctors has these racist biases seems to be unlikely to me. Especially because in the article it sounds like it's really just an assumption that the person didn't try to verify in any way. I have to admit that I can't think of many factors that would influence the numbers of prescriptions in such a drastic way though though. But still, I would prefer if actual research was done to find out what's happening before people draw their conclusions based on unfounded assumptions.

 

[Narz]

At first glance it seems to indeed imply that doctors would prescribe these drugs differently because of bias, but the idea that a large majority of doctors seems to be unlikely to me. Especially because in the article it sounds like it's really just an assumption that the person didn't try to verify in any way. I have to admit that I can't think of many factors that would influence the numbers of prescriptions in such a drastic way though though. But still, I would prefer if actual research was done to find out what's happening before people draw their conclusions based on unfounded assumptions.

Don't try to let logic get in the way of sensationalist headlines & claims, that's the bread & butter of modern reporting (well probably reporting since the beginning).

 

[warpus]

It's plausible that doctors might be more hesitant to prescribe painkillers to black patients because of the mistaken belief that blacks are more likely to abuse drugs.

Surely all of these doctors have access to the internet, which will tell them otherwise.

 

[Farm Boy]

The internet tells me a lot of things. It's like learning random technical crap from my physical-space friends, only the speakers on the internet have way less accountability.

 

[warpus]

Sure, but if you're a doctor, and you're about to prescribe a potentially addictive drug, surely it'd be easy enough to look up addiction rates for this drug somewhere. Surely doctors have a reliable go-to source they could query to find out if their internal fears are justified or not. If they're just going by their own internal prejudices, without doing their research, then they're just bad doctors.

 

[NovaKart]

I think the reason for the racial disparity is that drug use in poor rural areas has increased a lot and those areas are predominately white. It's been a problem in urban areas for awhile. I'm not sure about the male/female difference. Maybe it already was affecting men and women have caught up to the men.

When I was a kid few people in rural Kentucky did drugs but now it's really skyrocketed from what I hear from my relatives.

 

[emzie]

Well, the implication of women earning 77c for every Dollar a man earns is that bosses are biased against women.

Of course, if you look closer into it and check for other factors, such as job preference, hours worked, etc. - or directly compare men and women in very comparable positions, with a very comparable history - the wage gap closes for the most part, leaving only a few percent for biases against women and other factors that can't be checked for.

That's why I'm curious when I see a statistic like this.

At first glance it seems to indeed imply that doctors would prescribe these drugs differently because of bias, but the idea that a large majority of doctors has these racist biases seems to be unlikely to me. Especially because in the article it sounds like it's really just an assumption that the person didn't try to verify in any way. I have to admit that I can't think of many factors that would influence the numbers of prescriptions in such a drastic way though though. But still, I would prefer if actual research was done to find out what's happening before people draw their conclusions based on unfounded assumptions.

... unfounded assumption? Do you really think that it's unreasonable to assume unconscious bias might be a factor?

 

[Ryika]

... unfounded assumption? Do you really think that it's unreasonable to assume unconscious bias might be a factor?

Well, I think it's rather safe to assume that in any case it will probably be _a_ factor. The question is whether it's "the" factor, or even one of the big factors.

She however assumed that it's "the reason". And that's what I responded to.

So is her assumption unreasonable? No, not generally. Because of the scale 'Maybe'.

Unfounded? Yes, that seems to be the case. Unless she's actually basing that assumption on information that she didn't add to the article it's a wild guess.

/edit: Just realized it was the man who made that comment, not one of the women. That's the 'she' I'm referring to.

 

[BvBPL]

I

First you have to look at the medical setup that is present in the US. I have to assume that this high level of chronic pain in the poor is a result of acute medical problems that are not treated quickly and aggressively (or whatever is appropriate) turning into long term problems. I am lead to believe that it is very much more expensive to treat a long term condition than a short term one.

t?

I don't think that assumption is valid.

 

[Vectors]

Part of it is actually that people have an unconscious bias regarding pain tolerance of people of African descent that seriously underestimates their pain.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498378/