Socioeconomic status plays major role in opioid pain control

June 26, 2013, University of Rochester Medical Center
Socioeconomic status plays major role in opioid pain control

Patients in moderate to severe pain in emergency rooms across the U.S. are less likely to receive opioid pain medications if they are black, Hispanic, poor, or have less education, compared to more affluent patients, according to a University of Rochester Medical Center study reported in the Journal of General Internal Medicine.

The study took place against the backdrop of a national epidemic of narcotics abuse, combined with a need to satisfy patients' legitimate complaints of pain.

Racial and are already well-documented in the scientific literature, but the URMC team believes they are the first to investigate whether aspects of socioeconomic status—poverty, income and education levels—also influence the prescription of opioid .

The results point to a need for a national discussion to increase awareness and to provide consistent and unbiased treatments, said corresponding author Robert J. Fortuna, M.D., assistant professor of Medicine and Pediatrics and member of the Center for Primary Care, with a special research interest in improving .

Investigators analyzed a cross-section of data from the National Hospital Ambulatory Care Survey of people 18 and older from 2006 to 2009, which showed that more than 50,000 visits took place at approximately 1,400 emergency departments at which opioids were prescribed. They used zip codes to identify .

(Medications that fall within the opioid class include hydrocodone, e.g., Vicodin; oxycodone, e.g., OxyContin, Percocet; morphine, e.g., Kadian, Avinza; codeine, and related drugs.)

Results confirmed that people of black race or Hispanic ethnicity were less likely to get opioids for equivalent levels of pain. Similarly, people who resided in poorer neighborhoods were less likely to be treated with opioids than those from more affluent areas. For example, patients in the highest income neighborhoods received prescriptions 49 percent of the time for moderate to severe pain, versus 39 percent of the time for patients from lower income areas. Discrepancies also existed among various levels of poverty, with the poorest least likely to get opioids for pain. (Prior studies have documented similar outcomes based on race, even in cases where a patient has a bone fracture.)

Regional differences also were observed, with opioids prescribed more often at emergency departments in the South and West, compared to the Northeast. Although the study was not designed to answer why the disparities occur, the authors said the reasons are complex and should be investigated further. Co-authors Michael Joynt, M.D., and Meghan Train, D.O., a resident in the Department of Medicine at URMC, said that uniform standards and more medical education would help to promote unbiased prescribing.

Explore further: Long-term use of prescription painkillers for back pain linked to erectile dysfunction in men

More information: link.springer.com/article/10.1 … 07/s11606-013-2516-z

Related Stories

Long-term use of prescription painkillers for back pain linked to erectile dysfunction in men

May 15, 2013
Regularly taking prescription painkillers, also known as opioids, is associated with a higher risk of erectile dysfunction (ED) in men, according to a study published online today in the journal Spine.

Missing enzyme linked to drug addiction

June 17, 2013
A missing brain enzyme increases concentrations of a protein related to pain-killer addiction, according to an animal study. The results will be presented Monday at The Endocrine Society's 95th Annual Meeting in San Francisco.

Men taking long-acting chronic pain meds five times more likely to have low testosterone levels

January 31, 2013
Low testosterone levels occur five times more often among men who take long-acting instead of short-acting opioids for chronic pain, according to a new Kaiser Permanente study published in The Clinical Journal of Pain.

Opioid prescription is on the increase

February 12, 2013
More and more opioids are being prescribed for pain relief in Germany. This is the conclusion arrived at by Ingrid Schubert, Peter Ihle, and Rainer Sabatowski, whose study of a sample of inhabitants of the state of Hesse ...

Recommended for you

In most surgery patients, length of opioid prescription, number of refills spell highest risk for misuse

January 17, 2018
The possible link between physicians' opioid prescription patterns and subsequent abuse has occupied the attention of a nation in the throes of an opioid crisis looking for ways to stem what experts have dubbed an epidemic. ...

Patients receive most opioids at the doctor's office, not the ER

January 16, 2018
Around the country, state legislatures and hospitals have tightened emergency room prescribing guidelines for opioids to curb the addiction epidemic, but a new USC study shows that approach diverts attention from the main ...

FDA bans use of opioid-containing cough meds by kids

January 12, 2018
(HealthDay)—Trying to put a dent in the ongoing opioid addiction crisis, the U.S. Food and Drug Administration on Thursday slapped strict new restrictions on the use of opioid-containing cold and cough products by kids.

Taking ibuprofen for long periods found to alter human testicular physiology

January 9, 2018
A team of researchers from Denmark and France has found that taking regular doses of the pain reliever ibuprofen over a long period of time can lead to a disorder in men called compensated hypogonadism. In their paper published ...

Nearly one-third of Canadians have used opioids: study

January 9, 2018
Nearly one in three Canadians (29 percent) have used "some form of opioids" in the past five years, according to data released Tuesday as widespread fentanyl overdoses continue to kill.

Growing opioid epidemic forcing more children into foster care

January 8, 2018
The opioid epidemic has become so severe it's considered a national public health emergency. Addiction to prescription painkillers, such as oxycodone and morphine, has contributed to a dramatic rise in overdose deaths and ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.