The study is by Mark Pletcher and Stefan Kertesz (among others), two stalwarts in the Gen Med/Addiction world, so it is no surprise that the multivariable analysis appropriately controlled for insurance status. Sure enough, race was independently associated with receiving opioids over the entire time period of the analysis (1993-2005) even in light of an overall increase in the proportion of encounters during which opioids were prescribed regardless of race.
So, the bottom line is, blacks are less likely to get opioids for pain in the ED even when controlling for level of pain, insurance status, gender, and pain diagnosis, among other things.
The authors delicately discuss possible explanations, listing prejudice near the top but also alluding to systemic and latent factors that are exhaustively discussed in the ever-burgeoning disparities literature.
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