January 2, 2008 – White patients with pain are more likely to be prescribed opioids than minorities according to a new study this week in The Journal of the American Medical Association.
The article “Trends in Opioid Prescribing by Race/Ethnicity for Patients Seeking Care in U.S. Emergency Departments” cites national quality improvement initiatives implemented in the late 1990s, which were followed by substantial increases in opioid prescribing in the U.S. However, it was unknown whether opioid prescribing for treatment of pain in the emergency department varied depending on a patient’s race or ethnicity.
The study authors said pain-related issues accounted for 156,729 of 374,891 (42 percent) of visits to emergency departments between 1993 and 2005. Opioid prescribing for pain-related visits increased from 23 percent in 1993 to 37 percent in 2005, and this trend was more pronounced in 2001-2005. Over all years the study’s authors said white patients with pain were more likely to receive an opioid (31 percent) than black (23 percent), Hispanic (24 percent), or Asian/other patients (28 percent). These differences did not diminish over time, with opioid prescribing rates of 40 percent for white patients and 32 percent for all other patients in 2005.
The authors said differential prescribing by race/ethnicity was evident for all types of pain visits and was more pronounced with increasing pain severity, and was detectable for long-bone fracture and nephrolithiasis as well as among children. Statistical adjustment for pain severity and other factors did not substantially change these differences, with white patients remaining significantly more likely to receive an opioid prescription than black, Hispanic and Asian/other patients.
For more information: http://jama.ama-assn.org