Human biology is reasonably consistent between the sexes and races, although you get differences in reaction depending both on age and on what the medication is designed to achieve. So, for example, an aging liver processes drugs out of the bloodstream more slowly than in a younger body. So dosages have to be adjusted to ensure you do not produce an overdose of the drug in the bloodstream of an older patient. Similarly, drugs designed to change the level of hormones in the body either will have no effect on the “wrong” sex or produce rather unfortunate effects unless, of course, a sex change is being planned. That said, something like a painkiller is equally effective in all cases. The way the neurotransmitters send messages from one part of the brain to another is identical. So, if one group receives different treatment, the explanation cannot lie in the nature of the drug or what it is designed to do. There must be different explanations.

There’s a new piece of research published in the latest edition of the Journal of Pain. It was conducted at the Multidisciplinary Pain Center at the University of Michigan. To study the difference in experience before attending the center, each new black patent was matched with the next white patient of similar age and gender. The hypothesis under test was whether there was inequality in the care received at the primary heath level. For these purposes, it was assumed the Center itself was both racially and gender blind, giving the same quality of care regardless of the identity of each individual patient. All participants were asked to provide details of their treatment, and to offer their subjective opinions of the quality of the care they had received. It was clear that black patients and women received less equal treatment. The black patients were by and large more disabled than their equivalent male whites. They ability to function had been impaired and they did not enjoy as good a quality of life. Similarly, women were less likely to receive adequate pain management than men.

Allowing for there being a bias in self-reporting studies, this research raises disconcerting indications of a systemic discrimination on the grounds of race and gender with white males emerging with the best treatment at all ages. The study would be more convincing if the researchers had verified the patients’ recollection by consulting their medical records. This would have established more exactly what treatment they were given and how appropriate it was. But, as it stands, this should prompt urgent new research to discover whether there is real discrimination and, if so, how pervasive it is. Given that painkilling drugs like Tramadol are equally effective, it’s a terrible possibility that disadvantaged groups are simply not given an adequate supply of these drugs to control their pain. This would be a cruel and unnatural punishment. Until we have the answer, we hope black and female people will use the internet to get adequate medication (such as tramadol) to control their pain. Let’s not allow doctors to deny people the basic human right of being able to live without pain.