DESCRIMINATION IS PAINFUL. IT CAN ALSO BE AGONIZING

A study titled "We Don't Carry That" suggests that people who need medication for
severe pain may have trouble getting it if they live in neighborhoods
that are mostly black, Hispanic or Asian.

A survey of 347 pharmacies in New York City, conducted by the Mount
Sinai School of Medicine, found that in nonwhite neighborhoods only 25
percent of pharmacies carried enough morphine or morphine-like drugs
to treat severe pain; in white neighborhoods, 72 percent did.
Interviews with doctors and pharmacists in Los Angeles and the Midwest
suggested similar problems there.

Half the druggists blamed low demand, saying they could not afford to
stock items that customers did not buy. Some also cited onerous
narcotics laws and fear of theft in high-crime neighborhoods.

"I know some pharmacies who are very anxious about armed robberies and
will have signs saying that they don't carry narcotics," one
pharmacist said.

If demand is truly lower, no one knows why. Minorities are no less
likely than whites to suffer from illnesses that cause great pain.
Blacks, in fact, have higher cancer rates than whites.

Some pharmacists suggested that demand was lower in poor neighborhoods
because they had higher proportions of uninsured people who could not
afford to fill prescriptions.

But doctors who reviewed the survey said racial bias might be at work
because the results fit into a wider pattern of inequality in health
care, revealed by recent studies showing that blacks are less likely
than whites to be referred for kidney transplants or surgery for
early-stage cancer. "This study comes on the heels of many other
studies that have documented a disparity in treatment in which racial
and ethnic factors seem to be the predominant factor," said Dr.
Richard Payne, chief of the pain and palliative care service at
Memorial Sloan Kettering Cancer Center. "And that's quite
disturbing."

In addition, doctors are less likely to prescribe painkillers for
blacks and Hispanics with broken bones or postoperative pain, perhaps
because of the false perception that they are more likely to be
addicts or less likely to need treatment for pain.

DENISE GRADY