Blacks, Hispanics less likely to get strong pain drugs in emerg...( Despite increases in the overall use...),Health

Despite increases in the overall use of opioid drugs to relieve severe pain, black and Hispanic patients remain significantly less likely than whites to receive these pain-relievers in emergency rooms, according to a new national study.

The study examined treatments for more than 150,000 pain-related visits to U.S. hospitals between 1993 and 2005. It found that 31 percent of whites received opioid drugs compared with only 23 percent of blacks and 24 percent of Hispanics. About 28 percent of Asians received the drugs.

In contrast, non-opioid pain relievers, such as acetaminophen and ibuprofen were prescribed much more often to non-whites (36 percent) than to whites (26 percent).

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, said Mark Pletcher, MD, a UCSF assistant professor of epidemiology and biostatistics and lead author of the study. Unfortunately, this is not the case.

The study results are published in the January 2 issue of the Journal of the American Medical Association (JAMA).

Opioids are narcotic drugs used to treat patients with moderate to severe pain. Their use in emergency rooms increased overall from 23 to 37 percent between 1993 and 2005. National quality improvement guidelines on pain control in 2001 called for increased monitoring of pain status and stressed the need for adequate pain control. Since then, the hospital use of opioids has further increased. The new study is the first to assess national opioid prescribing patterns in the emergency room setting since implementation of the guidelines.

Among the findings:

• Blacks were prescribed opioids at lower rates than other groups for almost every type of pain-related emergency department visit, including back pain, headache, and
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