(CN) — While drug epidemics in the United States
tend to affect non-whites, the opioid crisis in America has targeted largely
low-income white populations, according to a new study released Monday by the
American Medical Association.
of the American Medical Association, the study found a 300 percent difference in the racial disparities
among people who consume opioids in California. The study authors, using
prescription drug data, researched records of 29.7 million people in California
who received a prescription opioid from 2011 to 2015.
The authors also looked at the prevalence of
stimulant prescriptions in the study area, which included 1,760 zip codes in
showed that 44.2 percent of adults in the zip codes with the lowest-income and
highest proportion of white population received at least one opioid
prescription per year. That compared to 16.1 percent of people in the highest
income/lowest proportion white population who received an opioid prescription.
discrepancies may have shielded non-white communities from the brunt of the
prescription opioid epidemic but also represent disparities in treatment and
access to all medications,” the study said. Across drug categories, controlled
medications were much more likely to be prescribed to individuals living in
majority-white areas, according to the study.
concentration of this epidemic in a racial/ethnic majority group is
epidemiologically noteworthy, and it speaks to the unique social context of the
current opioid crisis,” the study said.
epidemic killed more than 42,000 people in the United States in 2016 — more than
any previous year on record. Roughly 40 percent of opioid overdose deaths
involve a prescription opioid, according to the U.S. Department of Health and
has been described as a “disease of despair” and is linked to poverty and lack
of economic opportunity among increasingly downward mobile sectors of working
class America, Monday’s study said. The Department of Health and Human Services
in 2017 declared a public health emergency over opioids.
9,534 reported opioid overdose deaths in California from 2011 to 2015,
according to the study, and overdose deaths were highly concentrated in
lower-income and mostly white areas, revealing an approximate 10-fold
difference in overdose rates across the race/ethnicity–income gradient in
The overdose deaths included overdoses from any
opioid, including prescription medication, heroin and synthetic opioids like
crisis reveals how different racial groups have access to healthcare.
researchers in this study, healthcare professionals are more likely to
prescribe opioids to white patients than to racial or ethnic minority patients
who have the same medical symptoms.
Researchers said Hispanic patients were half as likely to
receive analgesics following major bone fractures than white patients, and
similar discrepancies in pain medication prescribing were found for black
“Recent studies have found that health care
professionals often underestimate the pain of black patients when compared with
white patients,” the study said.
crisis has also affected the rise in heroin use.
According to the JAMA study published Monday,
the majority of individuals who are dependent on heroin reported using a
prescription medication as their first opioid of abuse, which suggests that
healthcare professionals played an important role in the recent surge of
addiction and related overdoses.
between the health care system and opioid addiction may provide an explanation
for the observed racial/ethnic differences in the outcomes of the opioid
epidemic,” the study said.
study also showed vast discrepancies in prescription rates for stimulants in
the greater Los Angeles area.
stimulant prescriptions in zip codes from Malibu and Beverly Hills to south
central Los Angeles, these areas of higher-income, mostly white areas showed
”markedly elevated” rates of stimulant prescription prevalence, the study said.
Prescriptions for stimulants, such as
benzodiazepine, were highly concentrated in mostly white, high-income areas,
with 15.7 percent of adults in the areas with the highest proportion white
population receiving at least one prescription each year, compared with 7
percent among the lowest proportion white population.
In and around
Beverly Hills, roughly one of every four adults received a benzodiazepine
prescription during the study period. In the low-income, inner city
neighborhoods of Compton and Watts, that figure was one in 20 adults.
The study of
California prescription data showed that prescription rates for the stimulant
benzodiazepine were highest in the demographic of male adolescents ages 10 to
14 years old, suggesting that the largest contribution of stimulant
prescriptions is for the treatment of attention-deficit/hyperactivity disorder.
crisis in America was fueled in large part by marketing of opioids by pharmaceutical
companies, according to lawsuits targeting Purdue Pharma, the maker of
OxyContin, a synthetic opioid painkiller.
The annual number of prescriptions for OxyContin increased from
670,000 to 6.2 million between 1997 and 2002, and the total number of opioid
prescriptions increased by 45 million, according to the Mayo Clinic.
A federal court in 2007 found Purdue Pharma provided false
information about the addiction potential of OxyContin and fined the company