Addison quotes Kenneth Leonard, director of the Clinical and Research Institute on Addictions at the University of Buffalo explaining, “There is a bias issue there in terms of either believing [minorities are] more likely to be substance abusers or they can endure more pain.” The result is while overprescribing opioids is the most recent scourge in America’s war on drugs, under prescribing opioids to Hispanics is contributing to more and more addiction and death in those communities of color.

As Addison explains, “Indeed, a large body of research on racial equality in health care shows medical professionals hold falsehoods about the biological contrasts between patients of color and whites. Those viewpoints can perpetuate racial bias in the perception and treatment of non-white patients. These falsehoods can result in discrimination when dealing with pain treatment, with doctors overprescribing medication to whites and under-prescribing to non-whites.”

So, how do we evaluate the prescribing practices of Physicians? We can apply the 4D model. It groups Physician misprescribers as:

• Dated (not up to date on latest info)

• Duped (fooled by Patients requesting medication that is not warranted)

• Disabled (impaired by illness or substance abuse)

• Dishonest (willfully breaks rules for personal gain)

But this isn’t a fool-proof scale. Developing an awareness that such bias against persons of color, whether consciously or subconsciously exists, is our most powerful tool to reversing this inequity.  Until then, street opioids fill the void of prescription opioids for those in pain and/or addicted, and a shortage of bilingual treatment programs isolate the vulnerable Hispanic population.