Nearly a quarter of the patients filled prescriptions for opioid painkillers, a troubling finding because during encounters with doctors they had already indicated a dependence on opioids. Rates of filled prescriptions for benzodiazepines, like Xanax, Valium and Ativan, differed by race: 23.4 percent among Black patients, 29.6 percent among Latinos and 37.1 percent of white patients — all of which far exceeded rates of the patients’ acquisition of buprenorphine.
“A lot of these patients have chronic pain, for which they are receiving opioids, and they might have mental health comorbidities like anxiety that they might be getting benzos for, ” Dr. Barnett said. “Very often these patients will end up with more than one controlled substance, sometimes to counteract side effects from another. It’s a complex mix. But we know for sure that these meds are a very bad combination together.” The researchers also looked at a separate database of prescriptions filled for methadone, an older treatment medication. From 2020 through 2021, those numbers were also very low across all races, ranging from 8 to 11 percent.
The new study greatly expands upon earlier research about racial disparities in prematurely terminated addiction treatments. It also complements studies last month that underscored the lag in buprenorphine prescriptions, despite not only a clear need but considerable efforts , especially since the onset of the pandemic, to ease the regulation of providers who prescribe the medication.
Dr. Giselle Corbie, an expert on health equity research at the University of North Carolina School of Medicine who was not involved in the current study, described the results as a worrisome reflection of failures throughout the American health system.
“At multiple points along this cascade of treatment we are doing a poor job,” she said. “We need to be doing a better job of understanding the kinds of supports that need to be put around patients and around the clinicians that are caring for them, to ensure that these preventable death are averted. And so this study, to me, really is the canary in the coal mine.”