Trends in Opioid Prescribing by Race/Ethnicity for Patients Seeking Care in US Emergency Departments

CONTEXT National quality improvement initiatives implemented in the late 1990s were followed by substantial increases in opioid prescribing in the United States, but it is unknown whether opioid prescribing for treatment of pain in the emergency department has increased and whether differences in op...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2008-01, Vol.299 (1), p.70-78
Main Authors: Pletcher, Mark J, Kertesz, Stefan G, Kohn, Michael A, Gonzales, Ralph
Format: Article
Language:English
Subjects:
Analgesics, Opioid - therapeutic use
Drug Utilization - statistics & numerical data
Drug Utilization - trends
Emergency medical care
Emergency Service, Hospital - trends
Emergency Service, Hospital - utilization
Ethnic Groups - classification
Ethnic Groups - statistics & numerical data
Female
Health Care Surveys
Healthcare Disparities - statistics & numerical data
Healthcare Disparities - trends
Humans
Male
Narcotics
Pain - drug therapy
Pain - ethnology
Pain - etiology
Pain management
Practice Patterns, Physicians' - statistics & numerical data
Practice Patterns, Physicians' - trends
Prescription drugs
Quality Indicators, Health Care
Race
United States - epidemiology
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Summary:CONTEXT National quality improvement initiatives implemented in the late 1990s were followed by substantial increases in opioid prescribing in the United States, but it is unknown whether opioid prescribing for treatment of pain in the emergency department has increased and whether differences in opioid prescribing by race/ethnicity have decreased. OBJECTIVES To determine whether opioid prescribing in emergency departments has increased, whether non-Hispanic white patients are more likely to receive an opioid than other racial/ethnic groups, and whether differential prescribing by race/ethnicity has diminished since 2000. DESIGN AND SETTING Pain-related visits to US emergency departments were identified using reason-for-visit and physician diagnosis codes from 13 years (1993-2005) of the National Hospital Ambulatory Medical Care Survey. MAIN OUTCOME MEASURE Prescription of an opioid analgesic. RESULTS Pain-related visits accounted for 156 729 of 374 891 (42%) emergency department visits. Opioid prescribing for pain-related visits increased from 23% (95% confidence interval [CI], 21%-24%) in 1993 to 37% (95% CI, 34%-39%) in 2005 (P 
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2007.64