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Despite quality improvement initiatives, non-Hispanic white patients are still more likely to be treated with opioid analgesics than other racial groups, a new study suggests. Researchers examined opioid-prescribing patterns for pain-related visits to EDs from 1993 to 2005. They found that 42% of the 374,891 ED visits they evaluated were pain-related. Opioid use for such visits increased from 23% in 1993 to 37% in 2005, indicating that national quality improvement initiatives to improve analgesia have had a positive effect. But prescribing disparities still exist between white patients and other racial/ethnic groups.


In 2005, the opioid prescribing rates for white patients was 40%, compared with 32% for all other patients. Although the racial/ethnic prescribing gap existed for all types of pain, it was more pronounced with increasing pain severity.


The disparity could indicate that opioids are overprescribed to white patients, or that the expectations and assertiveness of certain patients create caregiver bias. Whatever the reasons, researchers call for new strategies to improve the quality and equity of pain management.


Source: Pletcher MJ, et al., Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments, JAMA, January 2, 2008.