Patients who are Asian, Black and Hispanic are less likely than whites to receive pain-relieving opioid drugs in emergency rooms.
For the study, researchers at the University of California - San Francisco (UCSF) examined treatments for more than 150,000 pain-related visits to U.S. hospitals between 1993 and 2005.
AdvertisementThey found that 31 percent of whites received opioid drugs compared to only 23 percent of blacks, 24 percent of Hispanics, and 28 percent of Asians.
In contrast, 36 percent of minority patients received less-potent, non-opioid pain relievers such as acetaminophen and ibuprofen during emergency room visits, compared to 26 percent of white patients.
"Studies in the 1990s showed a disturbing racial or ethnic disparity in the use of these potent pain relievers, but we had hoped that the recent national efforts at improving pain management in emergency departments would shrink this disparity. Unfortunately, this is not the case," said Mark Pletcher, MD, a UCSF assistant professor of epidemiology and biostatistics and lead author of the study.
The study showed that despite increases in the overall use of opioid drugs to relieve severe pain, blacks were prescribed the pain-relieving drugs at lower rates than other groups for almost every type of pain-related emergency department visit, including back pain, headache, and abdominal pain.
Researchers also found that differences in prescribing were greatest for people with the worst pain. About 52 percent of whites in severe pain received opioids, compared to 42 percent of Hispanics and 39 percent of blacks.
Prescribing rates were particularly low for black and Hispanic kids, blacks in county and state hospitals, Asians and other insured by Medicare, and all non-white patients in the Northeast.
"There is no evidence that non-whites have less severe or different types of pain when they arrive in the emergency department. We think our data indicate that opioids are being underprescribed to minority emergency department patients, especially black and Hispanic patients," Pletcher said.
The findings are based on data compiled by the National Hospital Ambulatory Medical Care Survey conducted by the Census Bureau. The researchers analysed nearly 375,000 emergency room visits over 13 years. About 42 percent of these visits were for pain.
The study is published in the January 2 issue of the Journal of the American Medical Association (JAMA).
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