“The prescription drug crisis should really be thought of as a double-sided epidemic,” says Joseph Friedman, the study’s lead author and a medical student at the
David Geffen School of Medicine at UCLA. “Essentially, the systematic racism within the health care system has led to increased addiction and overdoses in low-income white areas, but also, (to) insufficient treatment among communities of color.”
For example, in the poorest and whitest ZIP code areas in California analyzed by researchers, 44.2 percent of adults – defined as those 15 and older – received at least one opioid prescription per year on average, compared with 16.1 percent of adults in the richest, most racially diverse areas and 23.6 percent of adults across the state. In the state’s lowest-income, most racially diverse areas, meanwhile, 20.3 percent of adults were prescribed at least one opioid.
“If you’re living in Compton, you’re probably not getting a lot of prescribed opioids,” says Dr. David Schriger, who oversaw the research and is a professor of emergency medicine at UCLA. “You can’t tell me there are no prescriptions for opioids, so to speak, in
Compton because no one is in pain in Compton. It just defies logic.”
Stimulant prescriptions, meanwhile, were concentrated in mostly white, high-income areas, while benzodiazepines – medications that can be prescribed for anxiety such as Xanax, Valium and Diastat – were more prevalent in whiter areas, but did not significantly differ by income level.
The findings suggest race and class can outweigh a patient’s medical needs in determining who has access to prescription drugs, with consequences both “protective” and harmful, Schriger says. While the study notes that only a small fraction of prescriptions in a community represent an addiction or dependence, opioid overdose death rates in California have tended to be highest among low-income white communities that also have higher prescription rates.