Racial and ethnic disparities in opioid use for adolescents at US emergency departments

BMC Pediatrics

Michelle Fortier¹  Zeev Kain²  Brooke Jenkins³  Sun Yang⁴  Michael T. Phan⁴  Daniel M. Tomaszewski⁵  Candice Donaldson⁶  Cody Arbuckle⁷  Erik Linstead⁷ 

[1] Center on Stress & Health, University of California School of Medicine, Irvine, USA;Department of Anesthesiology and Perioperative Care, University of California, Irvine, USA;Department of Pediatric Psychology, Children’s Hospital of Orange County, Orange, CA, USA;Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA;Department of Psychological Science, University of California, Irvine, CA, USA;Center on Stress & Health, University of California School of Medicine, Irvine, USA;Department of Anesthesiology and Perioperative Care, University of California, Irvine, USA;Department of Pediatrics, CHOC Children’s, Orange, CA, USA;Yale Child Study Center, Yale University, New Haven, CT, USA;Center on Stress & Health, University of California School of Medicine, Irvine, USA;Department of Anesthesiology and Perioperative Care, University of California, Irvine, USA;Department of Psychology, Chapman University, 92866, Orange, CA, USA;Chapman University, School of Pharmacy, 92618, Irvine, CA, USA;Department of Pharmaceutical & Health Economics, University of Southern California, School of Pharmacy, University Park Campus, 635 Downey Way, Bldg. #331, 90089, Los Angeles, CA, USA;Irvine School of Medicine, University of California, 92617, Irvine, CA, USA;Schmid College of Science and Technology, Chapman University, 92866, Orange, CA, USA;

关键词: Pediatrics;    Adolescents;    Emergency department;    Ethnology;    Analgesics;    Pain;    National;    Young adult;    Minority;    Race;   

DOI  :  10.1186/s12887-021-02715-y

来源: Springer

【 摘 要 】

BackgroundRacial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED.MethodsThis was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11–21 years old were analyzed. Races/ethnicities were stratified as non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. In addition to race, statistical analysis included the following covariates: pain score, pain diagnosis, age, region, sex, and payment method.ResultsThere was a weighted total of 189,256,419 ED visits. Those visits involved 109,826,315 (58%) non-Hispanic Whites, 46,314,977 (24%) non-Hispanic Blacks, and 33,115,127 (18%) Hispanics, with 21.6% (95% CI, 21.1%-22.1), 15.2% (95% CI, 14.6–15.9%), and 17.4% (95% CI, 16.5–18.2%) of those visits reporting use of opioids, respectively. Regardless of age, sex, and region, non-Hispanic Whites received opioids at a higher rate than non-Hispanic Blacks and Hispanics. Based on diagnosis, non-Hispanic Whites received opioids at a higher rate in multiple pain diagnoses. Additionally, non-Hispanic Blacks and Hispanics were less likely to receive an opioid when reporting moderate pain (aOR = 0.738, 95% CI 0.601–0.906, aOR = 0.739, 95% CI 0.578–0.945, respectively) and severe pain (aOR = 0.580, 95% CI 0.500–0.672, aOR = 0.807, 95% CI 0.685–0.951, respectively) compared to non-Hispanic Whites.ConclusionsDifferences in the receipt of opioid agonists in EDs among the races/ethnicities exist, with more non-Hispanic Whites receiving opioids than their minority counterparts. Non-Hispanic Black women may be an especially marginalized population. Further investigation into sex-based and regional differences are needed.

【 授权许可】

CC BY