Racial Differences in Pain Medication Prescribed for Injury during Emergency Department Visits

Consistent evidence shows that racial minority individuals are overrepresented among those whose pain management is inadequate or ineffective. At the same time, the opioid epidemic has changed approaches to pain management.

The purpose of this study was to examine temporal trends over the course of the opioid epidemic, in racial and ethnic disparities in pain management strategies, for emergency department (ED) visits by patients with acute traumatic injury, to determine if these disparities are changing.

Data from the National Hospital Ambulatory Medical Care Survey were used to capture ED visits from the early 2000s, at the peak of the second wave of the U.S. opioid crisis, and the late 2010s. Visits were categorized by pain prescription type (narcotic, muscle relaxant, nonsteroidal anti-inflammatory drugs [NSAID], other analgesic, or no prescription) and were then compared between racial and ethnic groups.

Prescriptions for narcotics have significantly changed over time and there has been a recent switch from opioids to NSAIDs and other types of analgesia. Across all time periods, visits by non-Hispanic White patients were more likely to receive a narcotic prescription compared with non-Hispanic Black, Hispanic, and Other race counterparts. Trends in prescribing did not significantly differ by race and ethnicity between time periods.

These findings show that although pain prescription methods for ED visits have changed over time, differences between racial and ethnic groups have not.