"As a Hispanic professional, in my Mexican culture it is a sign of weakness to feel pain. Many of my white patients ask me for pain medicine," said Dr. Elda Ramirez, assistant professor of nursing in the emergency care division at the University of Texas, Houston. "Many of my nonwhite patients actually refuse pain medicine."
Other research in the past has pointed to racial discrepancies in pain drug prescription rates in other medical sectors.
However, despite major campaigns undertaken by the Joint Commission on Accreditation of Healthcare Organizations and the Veterans Health Administration in the late 1990s to introduce national standards for pain treatment and management, several studies have affirmed that major inequalities still exist in the quality of pain treatment offered to patients of different racial and ethnic backgrounds.
And previous studies based on the NHAMCS survey of U.S. emergency department visits also revealed alarming disparities in opioid prescribing between racial and ethnic groups suffering from back pain and migraine between 1997 and 1999.
Dr. Carmen Green, director of the Pain Research Division and associate professor of anesthesiology at the University of Michigan, conducted a number of studies comparing the differences in prescription rates of opioids to minority and white patients between 2003 and 2007.
What she and other researchers learned was that many doctors lacked familiarity with certain aspects of pain treatment.
"We found in a study several years ago that most doctors don't have pain education," Green said. "Pain is the No. 1 reason a patient sees an emergency department doctor, but they aren't well equipped to deal with these pain complaints."
In 2005, Green and her team of researchers at the University of Michigan published a report in the journal Pain that found great variability in physician's decision-making process for pain management.
According to the study, physicians across the country reported "lesser goals for chronic pain, and their prescribing habits differed on the basis of race, ethnicity, age, and gender, with the pain complaints of minorities, elderly persons, and women receiving less attention than the complaints of white men."
Among the additional barriers faced by minorities seeking adequate pain care, Green found that Michigan pharmacies in minority zip codes were 52 times less likely to carry an adequate supply of opioid analgesics than pharmacies in predominately white zip codes, regardless of income.
And the study released Tuesday suggests that many could be affected. Researchers noted the majority of all emergency department visits are pain-related visits, accounting for 156,729 of the 374,891 trips to the emergency department during the survey years.
And the National Center for Health Statistics reported in 2006 that 26 percent of Americans age 20 years and older — an estimated 76.5 million Americans — say that they suffer from pain.
Until six months ago, Posey was one of these million. It wasn't until her breast cancer returned in the middle of last year that her physician finally prescribed her a generic form of morphine to manage her pain.
For the first time in nine years, Posey said she was free from the pain of her arthritis.
"I don't have to use the cane all the time now," she said. "The swelling has gone down and I can walk on my own. Now I don't need people to constantly assist me to walk and I don't have to hear people always tell me they feel so sorry for me.
"But no one should have to wait until they get cancer to get chronic pain treatment."