Inadequate treatment of pain in United States emergency departments (EDs) is common, in part due to the limited and idiosyncratic use of opioids by emergency providers. We sought to determine the relationship between patient socioeconomic characteristics and the likelihood they would receive opioids during a pain-related ED visit. We conducted a cross-sectional analysis of ED data obtained as part of a multi-center study of outcomes after minor motor vehicle collision (MVC). Study patients were non-hispanic whites between the ages of 18–65 who were evaluated and discharged home from one of nine EDs in four states. Socioeconomic characteristics included educational attainment and income. Of 690 enrolled patients, the majority had moderate or severe pain (80%). Patients with higher education attainment had lower levels of pain, pain catastrophizing, perceived life-threat, and distress. More educated patients were also less likely to receive opioids during their ED visit. Opioids were given to 54% of patients who did not complete high school vs. 10% of patients with post-college education (chi-square test p<.001). Differences in the frequency of opioid administration between patients with the lowest educational attainment (39%, 95% CI 22%–60%)and highest educational attainment (13%, 95% CI 7%–23%) remained after adjustment for age, sex, income, and pain severity (p=.01). In this sample of post-MVCED patients, more educated patients were less likely to receive opioids. Further study is needed to assess the generalizability of these findings and determine the reason for the difference.
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