UMEM Educational Pearls

Substance use disorder is now known to be a function of brain disease and not a moral failure.  Patients with substance use disorder are highly complex and often use the ED at a higher frequency than those without the disorder.  However, these patients are also frequently the target of implicit bias and stigmatizing behavior from the healthcare team that can lead to worsened outcomes.  Add on top of that a racial disparity, and we can see how this group of patients can have really bad health outcomes.

This study looked at the length of time to treatment of patients with SUD, to see if there was a difference within this group based on racial or ethnic differences. It did find that black patients with SUD did wait on average 35% longer in the ED before being seen or treated.  This difference was statistically significant.

While this study wasn't designed to identify the causes of such a disparity, it does raise concern for implicit bias being in effect among not only the healthcare workers, but ingrained into the healthcare systems themselves.

Patient's with SUD are a vulnerable group of patients, and black patients with SUD are experiencing a disparity in time to treatment.  This should remind us all to seek out ways to remove these biases and disparities from the systems where we work.

References

Racial and Ethnic Differences in Emergency Department Wait Times for Patients with Substance Use Disorder

Open AccessPublished:March 01, 2023DOI:https://doi.org/10.1016/j.jemermed.2023.02.015