Study Finds Racial Disparity in Emergency Department Opioid Prescriptions
Dr. Astha Singhal, Assistant Professor in the Department of Health Policy and Health Services Research at Boston University Henry M. Goldman School of Dental Medicine (GSDM), published a study that found a racial disparity in the rate of opioid prescriptions for emergency department visits. Titled “Racial-Ethnic Disparities in Opioid Prescriptions at Emergency Department Visits for Conditions Commonly Associated with Prescription Drug Abuse,” the paper was published in PLOS ONE on July 27. The paper was co-authored by Yu-Yu Tien of the University of Iowa College of Pharmacy and Renee Y. Hsia of the University of California at San Francisco.
Dr. Singhal’s study has generated extensive national media coverage. The Guardian discussed the study in great detail, while the New York Times provided a link and citation and the Washington Post discussed the implications of their findings.
The team’s results show that black patients who visit emergency rooms with back and abdominal pain are significantly less likely to receive opioid prescriptions than white patients with the same pain level. These conditions are often characterized as ‘non-definitive conditions’. It is important to note that no difference was found for visits pertaining to fractures, kidney stones or toothaches. Given the increase of opioid addiction throughout the country, physicians and hospitals are under increased pressure to be vigilant when prescribing such medications. As such, doctors may be relying on subjective cues such as race when prescribing opioids for pain-related conditions.
The researchers conducted their experiment using the National Hospital Ambulatory Medical Care Survey (NHAMCS). Examining medications prescribed and administered in emergency departments over a five year period from 2007 -2011, they discovered a significant difference in the number of prescriptions administered for white versus black patients. No previous studies have examined such imbalances in opioid prescriptions at emergency department visits.
These results show that blacks who visit the emergency department with vague pain-related conditions are less likely to receive an opioid prescription than white patients, likely because blacks are more often stereotyped as a drug-seeker. Such discrimination could lead to an increase in existing racial disparities in health and pain-control. However, recent studies show an increase in drug abuse among whites. These discriminatory prescription practices could be a contributing factor.
“Access to healthcare and pain management decisions should be made without regard to patients’ race-ethnicity. Health care providers need to be sensitized to their inherent biases, so that they can consciously avoid these biases from affecting their practice behavior,” said Dr. Singhal.
“I applaud Dr. Singhal on her accomplishments and the success of her important research,” said Dean Jeffrey W. Hutter. “I am eager to see the impact it will have on the prescription of opioids in the future.”