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8/22/2000

Low Opioid Supplies Found in Some Pharmacies

Cheryl A. Thompson

Inadequate management of severe pain in nonwhite patients extends to their inability to obtain sufficient amounts of opioid analgesics from community pharmacies, asserted palliative care clinicians in the April 6 issue of New England Journal of Medicine.

Research assistants from New York City’s Hertzberg Palliative Care Institute telephoned a randomly selected 30 percent of the city’s community pharmacies to determine their opioid stock. After this initial contact, the assistants faxed the pharmacies information about the study. Information about the pharmacies’ neighborhoods was obtained from U.S. census estimates and local precincts.

Data obtained through the survey showed that 51 percent of the 347 participating pharmacies reported not having in stock either a long-acting or short-acting opioid product adequate for relieving severe pain. These pharmacies were overwhelmingly in neighborhoods where less than 40 percent of the residents were white. Some 54 percent of the pharmacists whose pharmacies had insufficient supplies of opioids for relieving severe pain reported not stocking these analgesics because of few prescriptions.

About 20 percent of participating pharmacists explained that their pharmacies did not routinely stock opioids such as morphine and oxycodone because of fear of theft and inappropriate use. Precinct reports, however, did not support the pharmacists’ fears.

In an accompanying editorial, two other New York City physicians raised the possibility that poor stocking of certain opioids by pharmacies in predominantly nonwhite neighborhoods stems from local physicians inappropriately treating pain in their communities.

To view the article’s abstract and the editorial, go to www.nejm.org/content/2000/0342/0014/1023.asp and www.nejm.org/content/2000/0342/0014/1045.asp.