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16 June 2026
Kase Cragg
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Categories: Resource

Examining Racial, Ethnic, and Gender Disparities in the Treatment of Pain and Injury Emergencies

Background: Racial, ethnic, and gender disparities in effective pain management have been well-documented across healthcare settings. However, discrepancies in the treatment of patients in prehospital pain management settings have not been well researched. The objective of this study was to determine whether Wyoming emergency medical service (EMS) providers’ use of opioids to treat prehospital pain or injury varies by patient race/ethnicity or gender. Methods: This cross-sectional study of EMS records examined 27 448 patient care reports (PCRs) generated during emergency medical responses to pain/injury emergencies in the state of Wyoming between January 2016 and March 2019. We included PCRs in the sample when 1) the primary impression was pain or injury, 2) the type of service was a 911 response, 3) the patient received treatment from and was transported by the EMS unit completing the PCR, and 4) the responding unit included one or more providers authorized to administer opioids. Results: The analysis identified a disparity in opioid administration by EMS providers during emergency transport (N = 27 448). Logistic regression reveals that EMS providers administered opioids to American Indian/Alaska Native patients (AI/AN) [n = 1610; 5.9%; P < .001; OR = 0.44] and those of Hispanic ethnicity (n = 1351; 4.9%; P = .001; OR = 0.74) at statistically significant lower rates (n = 14 769; 53.8%; P = .004; OR = 0.90) than they administer opioids to White patients. The analysis found EMS providers administer opioids to females at significantly lower rates (P = .004) compared to males.

Conclusion: Wyoming EMS providers administer opioids to White and male patients more often than non-White and female patients. Our results do not show a significant difference in the administration of opioids between White and Black patients. However, the data indicate a statistically significant difference between Hispanic, AI/AN, and White patients as well as between male and female patients.

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16 June 2026
Kase Cragg
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Opioid and High-Risk Prescribing Among Racial and Ethnic Minority Veterans

Abstract: 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.

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15 June 2026
Kase Cragg
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Categories: Resource

Racial Disparities in Anesthesia Care: A Systematic Review of Pain Management and Patient Outcomes

Abstract: Racial disparities in healthcare are a prominent issue that needs to be addressed to improve the quality of care for all patients. There are several disparities and biases related to the perceived pain tolerance people of color (POC) patients have and their need for analgesics. These biases lead to inadequate pain management and decreased health outcomes. Our study aims to highlight these disparities and how they impact the care patients receive, specifically in the field of anesthesia. To conduct this study, a comprehensive systematic literature search was performed, articles were included and removed according to specific inclusion and exclusion criteria, and a systematic review was performed. Sixteen papers that met the inclusion and exclusion criteria were selected, and after data collection, correlations between POC and pain tolerance were assessed throughout the articles. The studies reviewed showed that there may be some correlation between racial background and perceived pain tolerance. While some studies found that racial disparities may negatively impact the care POC patients receive, others found that there was no correlation at all. Regardless, more studies need to be conducted to assess the factors influencing the treatment of POC in anesthesia.

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15 June 2026
Kase Cragg
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Opioid Use Disorder and Racial/Ethnic Health Disparities: Prevention and Management

Abstract: This review aims to summarize risks and disparities associated with the prevalence and treatment of opioid use disorder in the perioperative and long-term setting, as well as evidence-based treatment and prevention targeted toward specific vulnerable populations.

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11 May 2026
Kase Cragg
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Categories: Resource

Disparities in Prehospital Non-Traumatic Pain Management

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While prior research has identified racial disparities in prehospital analgesia for traumatic pain, little is known about non-traumatic pain. Using a national prehospital dataset, we sought to evaluate for racial and ethnic disparities in analgesia given by EMS for non-traumatic pain.

Methods

We analyzed the 2018 and 2019 data from the ESO Data Collaborative, a collection of de-identified prehospital electronic health records from nearly 1,300 participating EMS agencies in the US. We included all transported, adult, non-traumatic encounters with a primary or secondary impression of a pain complaint, and we stratified encounters based on race and ethnicity as recorded by the EMS clinicians. We performed a mixed model analysis, modeling EMS agency as a random intercept and adjusting for age, sex, pain location, level of service, location of incident, and highest pain score. With non-Hispanic White patients as the reference group, we then evaluated the association between race/ethnicity and receiving any pain medication (acetaminophen, non-steroidal anti-inflammatories, or opioids), receiving opioid pain medication, and receiving pain medication within 20minutes of EMS arrival. Results: We included 1,035,486 patients; 67.5% non-Hispanic White, 26.8% Black, 4.9% Hispanic, 0.5% Asian, 0.1% Native Hawaiian or Other Pacific Islander, and 0.2% American Indian or Alaska Native patients. 4.7% of patients received pain medications. Compared to White patients (5.1%), Black patients were less likely to receive pain medication (3.3%, aOR 0.7; 95% CI 0.7-0.7) and Hispanics were more likely to receive pain medication (7.6%, aOR 1.5; 95% CI 1.4-1.6). Black patients were also less likely to receive opioids (1.8% for Black v 3.0% for White, aOR 0.7; 95% CI 0.6-0.7), while Hispanic patients were more likely to receive opioids (4.9%, aOR 1.4; 95% CI 1.3-1.5). The odds of receiving pain medication within 20minutes was lower for Black patients (aOR 0.9; 95% CI 0.8-0.95) but no different for Hispanic patients (aOR 1.0; 95% CI 0.9-1.1), when compared to White patients.

Conclusion: Pain medication administration is uncommon for non-traumatic pain complaints. While Black patients were less likely than White patients to receive pain medications and receive pain medication within 20minutes, Hispanics were more likely to receive pain medications.

10 March 2026
Kase Cragg
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Categories: Resource

Culture is Medicine: The United Katehnuaka Longhouse Good Mind Initiative as a Model of Indigenous Harm Reduction in Practice

The United Katehnuaka Longhouse is a Native-led, North Carolina-based nonprofit providing Indigenous harm reduction services in North Carolina and South Carolina through their Good Mind Initiative.

This report describes their approach to Indigenous harm reduction, their program model and impacts, considerations for funders and other prospective Indigenous harm reduction providers. It is a resource for other Indigenous communities looking to develop or expand harm reduction services or learn more about Indigenous harm reduction.

Indigenous-Harm-Reduction-in-Practice-GuideDownload

Learn more at their website here

27 January 2026
Kase Cragg
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Categories: Resource

Participant Perceptions of the Acceptability, Feasibility, and Perceived Impact of the Thiwáhe Gluwáš’akapi Substance Use Prevention Program for American Indian Youth

(1) Background: This study aimed to examine adult participants perceptions of the Thiwáhe Gluwáš’akapi (TG) program. We recruited 13 of 85 (15.3%) adult participants from various previous cohorts of the TG program, separated into lower and higher participation groups. Qualitative semi-structured interviews were conducted. This study was conducted on a Northern Plains reservation, and interviews took place via phone. (2) Methods: Semi-structured interviews with 13 adult participants with children aged 10–12 were completed. Audio files were transcribed and analyzed with ATLAS.ti. (3) Results: Qualitative analysis of these interviews revealed several themes: positive reception by families, enhanced connections to Lakota culture and community, and improved familial relationships. Several barriers to participation emerged, such as difficulties with transportation, scheduling conflicts, and lack of time, which can inform implementation strategies. Observed themes showcase positive impacts of TG on parent–child relationships and cultural connection, aiding overall wellbeing and substance use discourse. (4) Conclusions: Participants in the TG program expressed high satisfaction with the program, gained new skills, and improved family dynamics. Future implementation of TG should include additional transportation support and session scheduling options, in addition to updated implementation strategies to further improve Lakota families’ mental health and wellbeing.

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23 July 2025
Kase Cragg
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Early-Onset Alcohol Use among Native American Youth: Examining Female Caretaker Influence

This article investigates the influence of female caretaker substance use on early-onset youth drinking among Native American families in the Northern Midwest. Data include 603 Native American families, with reports from female caretakers and youths aged 10-13 years. Two potential caretaker influences are taken into account: adolescent modeling of caretaker behaviors and the effects of caretaker substance abuse on parenting.

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23 July 2025
Kase Cragg
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Perceived Discrimination and Early Substance Abuse among American Indian Children


This study investigated internalizing and externalizing symptoms as potential mediators of the relationship between perceived discrimination and early substance use among 195 American Indian 5th through 8th graders from three reservations that share a common culture (e.g., language, spiritual beliefs, and traditional practices) in the upper Midwest.

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22 July 2025
Kase Cragg
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Substance Use Among American Indians and Alaska Natives: Incorporating Culture in an “Indigenist” Stress-Coping Paradigm

This article proposes a new stress-coping model for American Indians and Alaska Natives (AIs) that reflects a paradigmatic shift in the conceptualization of Native health. It reviews sociodemographic information on AIs, rates of substance abuse and related health outcomes, and the research supporting the model’s pathways.

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Overdose Prevention Hub for Tribes and Native Communities

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The initiative for establishing an online one-stop native overdose prevention resource hub came about as one component of the U.S. Centers for Disease Control’s Opioid Overdose Prevention in Tribes. Learn More

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