Study Notes Racial Disparities in Opioid Prescriptions

Although underserved patients often turn to hospital emergency departments for routine dental care, emergency departments can’t treat dental conditions — they can only prescribe medication to ease pain. This led investigators at Boston University’s Henry M. Goldman School of Dental Medicine, University of California, San Francisco Medical Center, and the University of Iowa to question whether some patients visit the hospital citing dental pain just to obtain prescription opioids. After reviewing the data, no evidence of this link was found, but the research suggests the possibility of racial bias in opioid prescriptions written by emergency department personnel.

In a study published in PLOS One, “Racial-Ethnic Disparities in Opioid Prescriptions at Emergency Department Visits for Conditions Commonly Associated with Prescription Drug Abuse,” data was extracted from the National Ambulatory Medical Care Survey, which contains 60 million emergency department records from visits between 2007 and 2011 in the United States. The researchers focused on adults between 18 and 65 who presented with definitive pain (such as a fracture) and nondefinitive pain (a toothache, for example).

The evidence demonstrates that when it comes to opioid prescriptions, racial disparities exist, especially for complaints of back or abdominal pain. Non-Hispanic blacks were 50% to 67% less likely to receive opioids for back and abdominal pain than non-Hispanic whites. This led researchers to speculate that whites have greater access to opioids, and may contribute to abuse of such drugs. Additionally, they suggest provider bias may contribute to racial disparities in pain prescriptions. Such evidence brings to light that hidden biases have the potential to influence health care decisions — and serves as a reminder that oral health professionals should remain neutral when delivering care.