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Racial differences in opioid prescribing for children in the United States

Groenewald, Cornelius B.a,*; Rabbitts, Jennifer A.a; Hansen, Elizabeth E.a; Palermo, Tonya M.a,b,c

doi: 10.1097/j.pain.0000000000001290
Research Paper
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Global Year 2018

Racial differences exist in analgesic prescribing for children during emergency department and ambulatory surgery visits in the United States; however, it is unknown whether this is true in the outpatient setting. We examined racial and ethnic differences in outpatient analgesic prescribing using nationally representative data from 113,929 children from the Medical Expenditure Panel Survey. We also examined whether patient–provider race and ethnic concordance was associated with opioid prescription. White children were more commonly prescribed opioids as compared to minorities (3.0% vs 0.9%-1.7%), except for Native American children who had similar rates of opioid prescription (2.6%) as white children. Minorities were more likely to receive nonopioid analgesics than white children (2.0%-5.7% vs 1.3%). Although most white children had race-concordant providers (93.5%), only 34.3% of black children and 42.7% of Hispanic children had race-concordant providers. Among black children, having a race concordant usual source of care provider was associated with a decreased likelihood of receiving an opioid prescription as compared to having a white usual source of care provider (adjusted odds ratio [95% confidence interval] = 0.51 [0.30-0.87]). For all other racial groups, patient–provider race-concordance was not associated with likelihood of opioid prescription. Racial differences exist in analgesic prescriptions to children at outpatient health care visits in the United States, with white children more likely to receive opioids and minorities more likely to receive nonopioid analgesics. Health care providers' race and ethnicity may play a significant role in extant analgesic differences. Further work should focus on understanding the role of provider race and ethnicity in analgesic differences to children in the United States.

Race and ethnic differences exist in opioid prescribing for children in the United States. Health care providers' race and ethnicity may drive extant opioid differences.

Departments of aAnesthesiology and Pain Medicine

bPediatrics, and

cPsychiatry, University of Washington School of Medicine, Seattle, WA, United States

Corresponding author. Address: Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, M/S MB.11.500.3, 4800 Sand Point Way NE, Seattle, WA 98105, United States. Tel.: +1 206 987 2518. E-mail address: cornelius.groenewald@seattlechildrens.org (C.B. Groenewald).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Received January 08, 2018

Received in revised form May 03, 2018

Accepted May 17, 2018

© 2018 International Association for the Study of Pain
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