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Poor people get fewer painkillers from ER docs, study finds

June 26, 2013
Courtesy of Uni­vers­ity of Roch­es­ter Med­i­cal Cen­ter
and World Science staff

Pa­tients in mod­er­ate to se­vere pain in U.S. emer­gen­cy rooms are less likely to get some of the strongest painkillers if they’re black, His­pan­ic, poor, or less ed­u­cat­ed, a study re­ports.

The study from the Uni­vers­ity of Roch­es­ter Med­i­cal Cen­ter in New York, re­ported in the Jour­nal of Gen­er­al In­ter­nal Med­i­cine, looked at how doc­tors pre­scribe opi­oid med­ica­t­ions such as hy­dro­co­done, mor­phine and oxy­co­done, which is al­so sold as Oxy­Con­tin. 

Opi­oids tend to be easily abused. There’s a na­t­ional ep­i­dem­ic of such abuse—a con­cern doc­tors must con­stantly bal­ance against le­git­i­mate com­plaints of pain.

The find­ings point to a need for a na­t­ional dis­cus­sion to in­crease aware­ness and to pro­vide con­sist­ent and un­bi­ased treat­ments, said Rob­ert J. For­tu­na, co-author of the stu­dy. Co-authors Mi­chael Joynt and Me­ghan Train sug­gested un­iform stan­dards and more med­ical educa­t­ion would help.

The sci­en­tists an­a­lyzed a cross-sec­tion of da­ta from the Na­t­ional Hos­pi­tal Am­bu­la­to­ry Care Sur­vey of peo­ple 18 and old­er from 2006 to 2009. They data, they said, showed that more than 50,000 vis­its took place at about 1,400 emer­gen­cy de­part­ments where opi­oids were pre­scribed. The re­search­ers used zip codes to iden­ti­fy so­ci­o­ec­on­omic sta­tus, and also re­viewed past stu­dies.

They found that 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. Opi­oids were also pre­scribed more of­ten in the South and West, com­pared to the North­east.


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Patients in moderate to severe pain in U.S. emergency rooms are less likely to get some of the strongest painkillers if they’re black, Hispanic, poor, or less educated, a study reports. The study from the University of Rochester Medical Center in New York, reported in the Journal of General Internal Medicine, examined how doctors prescribe opioid medications such as hydrocodone, morphine and oxycodone, which is also sold as OxyContin. Opioids tend to be easily abused. A national epidemic of such abuse is a concern doctors must constantly balance against legitimate complaints of pain. The findings point to a need for a national discussion to increase awareness and to provide consistent and unbiased treatments, said Robert J. Fortuna, co-author of the study. Co-authors Michael Joynt and Meghan Train suggested uniform standards and more medical education would help. The scientists 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 about 1,400 emergency departments where opioids were prescribed. They used zip codes to identify socioeconomic status. They found that 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. Opioids prescribed also more often at emergency departments in the South and West, compared to the Northeast.