ASPO Abstracts

Opiates for Cancer Pain in Harlem

Authors: Rhaisili Rosario, Victoria Berges, Geetanjali Kamath, Kezhen Fei, Lina Jandorf, Nina A. Bickell

Category: Cancer Health Disparities
Conference Year: 2020

Abstract Body:
Purpose: To determine whether national trends to restrict opiate prescribing impact cancer patients’ access to opiates. Methods: We surveyed residents from Central Harlem (CH) (n=480) and East Harlem (EH) (n=498), predominantly minority and poor neighborhoods and the Upper East Side (UES) (n=224), a predominantly white and wealthy neighborhood. Half our cohort (n=598) were randomly sampled from an academic medical center’s data warehouse; 18% had a cancer diagnosis. Half (n=604) were recruited from the community; 10% had a cancer diagnosis. We recruited via street fairs (23%), friends or family (23%), flyers posted in the neighborhood (18%), public housing (12%), community-based organizations (9%), the street (8%), faith-based organizations (8%) & senior centers (6%). We compared residents’ reports of ease of availability of prescribed opiate medication for cancer patients’ pain. Results: Among 1202 respondents, 10% (114/1173) reported personally needing or knowing someone with cancer who needed opiates for cancer pain relief, 19% of whom had a personal history of cancer. Rate of prior history of cancer differed by neighborhood (CH: 10%, EH, 13%, UES: 23%, p<.0001), and by race (B: 10%, H: 11%, W: 22%, p<.0001). Among people who ever had cancer (N=37), 26% experienced pain caused by cancer and of these, 36% (5/14) who had cancer pain reported difficulty getting opiates for cancer pain. Of those knowing someone with cancer pain, 39% of residents in CH (p=0.05) and 29% of East Harlem (p=0.2) as compared to 14% of UES reported that it was hard to obtain opiate medication. There was no racial difference in difficulty obtaining the medication (B=33%; H= 33%; W=14%; p=0.24). Conclusion: In the nearly 2 decades since disparities in availability of opiates in NYC pharmacies were described, we find little has changed. Access to opiates for cancer patients in poorer predominantly minority neighborhoods appears to remain significantly lower than in a wealthier, predominantly white neighborhood.

Keywords: cancer patients’ access to opiates