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Patient Race and Opioid Misuse History Influence Provider Risk Perceptions for Future Opioid-Related Problems.

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Bibliographic Details
Title:	Patient Race and Opioid Misuse History Influence Provider Risk Perceptions for Future Opioid-Related Problems.
Authors:	Hirsh, Adam T.¹ athirsh@iupui.edu, Anastas, Tracy M.¹, Miller, Megan M.¹, Quinn, Patrick D.², Kroenke, Kurt³
Source:	American Psychologist. Sep2020, Vol. 75 Issue 6, p784-795. 12p.
Subject Terms:	Attitude (Psychology), Black people, Drug addiction, Case studies, Substance abuse risk factors, Analgesics, Drugs, Medical personnel, Minorities, Narcotics, Race, Risk perception, Substance abuse, Video recording
Abstract:	In response to the dual public health crises of chronic pain and opioid use, providers have become more vigilant about assessing patients for risk of opioid-related problems. Little is known about how providers are making these risk assessments. Given previous studies indicating that Black patients are at increased risk for suboptimal pain care, which may be related to stereotypes about drug abuse, the current study examined how patient race and previous opioid misuse behaviors impact providers' risk assessments for future prescription opioid-related problems. Physician residents and fellows (N = 135) viewed videos and read vignettes about 8 virtual patients with chronic pain who varied by race (Black/White) and history of prescription opioid misuse (absent/present). Providers rated patients' risk for future prescription opioid-related adverse events, misuse/abuse, addiction, and diversion, and also completed measures of implicit racial attitudes and explicit beliefs about race differences in pain. Two significant interactions emerged indicating that Black patients were perceived to be at greater risk for future adverse events (when previous misuse was absent) and diversion (when previous misuse was present). Significant main effects indicated that Black patients and patients with previous misuse were perceived to be at greater risk for future misuse/abuse of prescription opioids, and that patients with previous misuse were perceived to be at greater risk of addiction. These findings suggest that racial minorities and patients with a history of prescription opioid misuse are particularly vulnerable to any unintended consequences of efforts to stem the dual public health crises of chronic pain and opioid use. Public Significance Statement: This study found that, in the context of chronic pain care, patient race and previous opioid misuse impact providers' risk assessments for future opioid-related problems. These findings suggest that efforts to address the dual public health crises of chronic pain and opioid use may have unintended negative consequences for certain patient groups. [ABSTRACT FROM AUTHOR]
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Database:	Education Research Complete

Description
Abstract:	In response to the dual public health crises of chronic pain and opioid use, providers have become more vigilant about assessing patients for risk of opioid-related problems. Little is known about how providers are making these risk assessments. Given previous studies indicating that Black patients are at increased risk for suboptimal pain care, which may be related to stereotypes about drug abuse, the current study examined how patient race and previous opioid misuse behaviors impact providers' risk assessments for future prescription opioid-related problems. Physician residents and fellows (N = 135) viewed videos and read vignettes about 8 virtual patients with chronic pain who varied by race (Black/White) and history of prescription opioid misuse (absent/present). Providers rated patients' risk for future prescription opioid-related adverse events, misuse/abuse, addiction, and diversion, and also completed measures of implicit racial attitudes and explicit beliefs about race differences in pain. Two significant interactions emerged indicating that Black patients were perceived to be at greater risk for future adverse events (when previous misuse was absent) and diversion (when previous misuse was present). Significant main effects indicated that Black patients and patients with previous misuse were perceived to be at greater risk for future misuse/abuse of prescription opioids, and that patients with previous misuse were perceived to be at greater risk of addiction. These findings suggest that racial minorities and patients with a history of prescription opioid misuse are particularly vulnerable to any unintended consequences of efforts to stem the dual public health crises of chronic pain and opioid use. Public Significance Statement: This study found that, in the context of chronic pain care, patient race and previous opioid misuse impact providers' risk assessments for future opioid-related problems. These findings suggest that efforts to address the dual public health crises of chronic pain and opioid use may have unintended negative consequences for certain patient groups. [ABSTRACT FROM AUTHOR]
ISSN:	0003066X
DOI:	10.1037/amp0000636