Opioid Prescribing Disparity in Traumatically Injured Patients.

Area of Science:

• Trauma Surgery
• Pain Management
• Health Disparities

Background:

• Opioid prescribing patterns in trauma patients are not well-understood.
• Disadvantaged communities are disproportionately represented in trauma populations.
• This study investigates disparities in opioid administration following trauma injuries.

Purpose of the Study:

• To evaluate racial and ethnic disparities in opioid administration among trauma patients.
• To identify factors influencing opioid prescribing patterns throughout hospitalization and at discharge.
• To examine differences in milligram morphine equivalents (MMEs) and pain control days based on patient demographics and clinical factors.

Main Methods:

• Retrospective cohort study of adult trauma patients (2018-2021) at a Level I trauma center.
• Opioid doses quantified in milligram morphine equivalents (MMEs).
• Multivariable regression models analyzed factors associated with opioid receipt, MMEs, and pain control days.

Main Results:

• Non-White patients, including Black and Hispanic individuals, received significantly lower MMEs during inpatient care.
• Factors associated with lower odds of receiving opioids at discharge included non-English language, substance use disorder, neuropsychiatric comorbidity, and violent injury.
• Black patients received lower MMEs at discharge, and patients with substance use disorder had fewer pain control days prescribed.

Conclusions:

• Significant disparities in opioid prescribing exist for trauma patients throughout their hospitalization.
• Non-White patients received lower opioid doses, indicating potential inequities in pain management.
• Patient language, mental health comorbidities, and injury mechanism influenced discharge opioid prescriptions.