For a study, researchers sought to examine the National Hospital Ambulatory Medical Care Survey (NHAMCS) database for regional and temporal patterns, as well as characteristics linked with the chance of getting an opioid prescription for urolithiasis in emergency departments (EDs) throughout the United States (US).

The NHAMCS database was searched for all ED visits for urolithiasis between 2006 and 2018. Age, race/ethnicity, insurance status, ED provider qualifications, geographic location, and hospital status (urban vs. rural) were retrieved. To analyze overall/regional changes in opioid prescriptions over time, linear regression was utilized. To assess parameters linked with a higher likelihood of obtaining opioids, logistic regression was utilized.

About 14 million visits were examined, with 79.1% (11.0 million) receiving an opioid prescription. From 2014 to 2018, the proportion of visitors obtaining an opioid prescription decreased by 3.65% each year (R2= 0.86, P=.008). When compared to Non-Hispanic Whites (NHW), Non-Hispanic Blacks had a reduced risk of acquiring an opioid prescription (OR=0.57, P=.02). When compared to the Northeast, Midwestern hospitals had a greater rate of opioid prescription (OR=2.05, P=.006). When compared to urban hospitals, rural hospitals had reduced probabilities of opioid prescription (OR=0.62, P=.02).

Except in the Midwest, opioid prescriptions for patients presenting to the ED with urolithiasis have progressively reduced from 2014 to 2018. The chance of obtaining opioids increases with NHW race, Midwest area, and urban EDs. Continued efforts to encourage non-opioid options for urolithiasis, particularly in Midwestern EDs, are critical to mitigating the US opioid crisis.