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Review
. 2024 Nov 7:17:3639-3649.
doi: 10.2147/JPR.S477128. eCollection 2024.

Racial Disparities in Opioid Prescribing in the United States from 2011 to 2021: A Systematic Review and Meta-Analysis

Salman Hirani #  1 , Barlas Benkli #  1 , Charles A Odonkor  2 , Zishan A Hirani  3   4   5 , Tolulope Oso  6 , Siri Bohacek  1 , Jack Wiedrick  7 , Andrea Hildebrand  7 , Uzondu Osuagwu  8 , Vwaire Orhurhu  9   10 , W Michael Hooten  11 , Salahadin Abdi  8 , Salimah Meghani  12   13
Affiliations
Review

Racial Disparities in Opioid Prescribing in the United States from 2011 to 2021: A Systematic Review and Meta-Analysis

Salman Hirani et al. J Pain Res. .

Abstract

Background: This meta-analysis is an update to a seminal meta-analysis on racial/ethnic disparities in pain treatment in the United States (US) published in 2012. Since then, literature has accumulated on the topic and important policy changes were made.

Objective: Examining racial/ethnic disparities in pain management and investigating key moderators of the association between race/ethnicity and pain outcomes in the US.

Methods: We performed a systematic search of publications (between January 2011 and February 2021) from the Scopus database. Search terms included: race, racial, racialized, ethnic, ethnicity, minority, minorities, minoritized, pain treatment, pain management, and analgesia. All studies were observational, examining differences in receipt of pain prescription medication in various settings, across racial or ethnic categories in US adult patient populations. Two binary analgesic outcomes were extracted: 1) prescription of "any" analgesia, and 2) prescription of "opioid" analgesia. We analyzed these outcomes in two populations: 1) Black patients, with White patients as a reference; and 2) Hispanic patients, with non-Hispanic White patients as a reference.

Results: The meta-analysis included twelve studies, and the systematic review included forty-three studies. Meta-analysis showed that, compared to White patients, Black patients were less likely to receive opioid analgesia (OR 0.83, 95% CI [0.73-0.94]). Compared to non-Hispanic White patients, Hispanic patients were less likely to receive opioid analgesia (OR 0.80, 95% CI [0.72-0.88]).

Conclusion: Despite a decade's gap, the findings indicate persistent disparities in prescription of, and access to opioid analgesics for pain among Black and Hispanic populations in the US.

Keywords: disparities; ethnicity; pain management; race.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Prisma Flow Diagram. Preferred reporting items for systematic and meta-analyses flowchart. (A) These studies included randomized controlled trials, prospective observational cohort and retrospective studies. (B) Studies were included in meta-analysis if they contained all of the following: specified analgesic outcomes, odds-ratio results, reported dates for study period and data collection, sample size, type of pain, pain treatment setting, provided racial and ethnic breakdown, reported relevant disparity outcomes and study confounders.
Figure 2
Figure 2
Receipt of opioids, Black vs White (A) Meta-Analysis; (B) Asymmetry Analysis.
Figure 3
Figure 3
Receipt of any analgesic, Black vs White (A) Meta-Analysis; (B) Asymmetry Analysis.
Figure 4
Figure 4
Receipt of opioids, Hispanic vs Non-Hispanic White (A) Meta-Analysis; (B) Asymmetry Analysis.
Figure 5
Figure 5
Receipt of any analgesic, Hispanic vs Non-Hispanic White (A) Meta-Analysis; (B) Asymmetry Analysis.
See this image and copyright information in PMC

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