Opioid and High-Risk Prescribing Among Racial and Ethnic Minority Veterans.

Suda KJ, Boyer TL, Blosnich JR, Cashy JP, Hubbard CC, Sharp LK. Opioid and High-Risk Prescribing Among Racial and Ethnic Minority Veterans. American journal of preventive medicine. 2023 Nov 1; 65(5):863-875.

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Abstract:

INTRODUCTION: The purpose of this study is to compare opioid prescribing and high-risk prescribing by race and ethnicity in a national cohort of U.S. veterans. METHODS: A cross-sectional analysis of veteran characteristics and healthcare use was performed on electronic health record data for 2018 Veterans Health Administration users and enrollees in 2022. RESULTS: Overall, 14.8% received an opioid prescription. The adjusted odds of being prescribed an opioid were lower for all race/ethnicity groups than for non-Hispanic White veterans, except for non-Hispanic multiracial (AOR = 1.03; 95% CI = 0.999, 1.05) and non-Hispanic American Indian/Alaska Native (AOR = 1.06; 95% CI = 1.03, 1.09) veterans. The odds of any day of overlapping opioid prescriptions (i.e., opioid overlap) were lower for all race/ethnicity groups than for the non-Hispanic White group, except for the non-Hispanic American Indian/Alaska Native group (AOR = 1.01; 95% CI = 0.96, 1.07). Similarly, all race/ethnicity groups had lower odds of any day of daily dose > 120 morphine milligram equivalents than the non-Hispanic White group, except for the non-Hispanic multiracial (AOR = 0.96; 95% CI = 0.87, 1.07) and non-Hispanic American Indian/Alaska Native (AOR = 1.06; 95% CI = 0.96, 1.17) groups. Non-Hispanic Asian veterans had the lowest odds for any day of opioid overlap (AOR = 0.54; 95% CI = 0.50, 0.57) and daily dose > 120 morphine milligram equivalents (AOR = 0.43; 95% CI = 0.36, 0.52). For any day of opioid-benzodiazepine overlap, all races/ethnicities had lower odds than non-Hispanic White. Non-Hispanic Black/African American (AOR = 0.71; 95% CI = 0.70, 0.72) and non-Hispanic Asian (AOR = 0.73; 95% CI = 0.68, 0.77) veterans had the lowest odds of any day of opioid-benzodiazepine overlap. CONCLUSIONS: Non-Hispanic White and non-Hispanic American Indian/Alaska Native veterans had the greatest likelihood to receive an opioid prescription. When an opioid was prescribed, high-risk prescribing was more common in White and American Indian/Alaska Native veterans than in all other racial/ethnic groups. As the nation's largest integrated healthcare system, the Veterans Health Administration can develop and test interventions to achieve health equity for patients experiencing pain.