Blacks and Hispanics who go to hospital emergency departments in pain are significantly less likely than whites to get pain-relieving opioid drugs, according to a new study funded by the U.S. Department of Health and Human Services.
The study, which analyzed treatments for more than 150,000 pain-related visits to U.S. hospitals between 1993 and 2005, found 23 percent of blacks and 24 percent of Hispanics received opioids compared with 31 percent of whites. Twenty-eight percent of Asians and other groups received opioids.
“This study provides a particularly compelling reminder that treatment disparities persist among racial and ethnic groups,'' said Carolyn M. Clancy, M.D., director of the HHS Agency for Healthcare Research and Quality. “We have a lot of work to do before high-quality health care is available to everyone.”
The study, “Trends in Opioid Prescribing by Race/Ethnicity for Patients Seeking Care in US Emergency Departments,” was published in the January 2 issue of JAMA. The research was funded by AHRQ and the National Institute on Drug Abuse, part of the National Institutes of Health.
“Minority health disparities are an urgent problem in this country,” noted Nora Volkow, M.D., director of the NIDA, “and should be addressed through efforts to educate physicians, reduce stigma and promote cultural competence across all health care settings.”
Opioids are narcotic pain medications used to treat patients with moderate to severe pain. The new study analyzed the use of several commonly prescribed opioids, including hydrocodone, meperidine, morphine, codeine and oxycodone.
Among patients in pain in emergency departments, the use of opioids increased from 23 percent in 1993 to 37 percent in 2005. That trend accelerated in 2001 when The Joint Commission, which accredits health care organizations, and the U.S. Department of Veterans Affairs initiated campaigns to improve the quality of pain control in hospitals. The new study is the first to measure opioid prescribing trends since those efforts.
The study is based on data compiled by the National Hospital Ambulatory Medical Care Survey, which is administered by the U.S. Census Bureau. Study authors, led by University of California-San Francisco researcher Mark J. Pletcher, M.D., M.P.H., analyzed 374,891 emergency department visits over 13 years. Of those visits, 156,729, or 42 percent, were related to pain.
Among the study findings: