Recent research has shown that a combination of pain medications, known as multimodal analgesia, can be more effective than opioids alone for managing post-surgery pain, but Black patients are less likely to receive this type of care. In a study presented at the American Society of Anesthesiologists’ annual meeting, researchers found that Black patients recovering from major surgeries were more often prescribed opioids and less likely to be given multimodal pain management compared to White patients.
Multimodal analgesia involves the use of various types of medications to manage pain, reducing the need for opioids and potentially offering better pain relief. Experts advocate for this approach because it decreases reliance on opioids, which carry a high risk of addiction. Dr. Nauder Faraday, one of the study’s authors, explained that patients should ask their doctors before and after surgery how their pain will be managed and what medications will be prescribed, emphasizing patient involvement in their care decisions.
The study, which analyzed data from surgeries at Johns Hopkins Hospital between 2016 and 2021, found significant racial disparities. Black patients were 74% more likely to be prescribed opioids for post-surgery pain management and 29% less likely to receive multimodal analgesia with four or more pain management methods. This gap persisted even though both racial groups generally received multimodal treatment with two or three methods.
These findings suggest a racial disparity in pain management practices, but more research is needed to explore whether similar disparities exist among other racial and ethnic groups. The study also did not assess the patients’ self-reported pain levels, which could provide deeper insight into whether Black patients were being undertreated relative to their pain.
Other studies have also highlighted racial disparities in pain management. Research conducted by Dr. Eli Carrillo at Stanford found that Black and Brown patients with traumatic injuries were less likely to have their pain levels recorded, and those with high pain scores were less likely to receive adequate pain relief. This issue extends beyond the quality of life, as improper pain management can increase the risks associated with opioid use and negatively impact patients’ willingness to engage with the healthcare system.
Anesthesiologist Dr. Dionne Ibekie supports using multimodal analgesia to reduce opioid prescriptions and improve pain control. She notes that systemic biases in pain treatment contribute to racial disparities, with Black patients consistently receiving less effective pain management across various medical settings, including emergency rooms and during obstetric care.
These findings align with past research showing that medical racism, including unconscious bias, affects the way Black patients’ pain is assessed and treated. Studies have found that physicians are more likely to underestimate pain in Black patients and that false beliefs about biological differences between Black and White patients continue to influence treatment decisions.
Further evidence of racial disparities in healthcare was highlighted in another study presented at the anesthesiology meeting, which found that Black and Hispanic trauma patients were less likely to receive timely helicopter transport for urgent care compared to White patients, despite the survival benefits of air transport. These disparities show the ongoing challenges in achieving equitable healthcare for all racial and ethnic groups.
