To explore patterns of opioid versus non-opioid medication use over time for different demographic groups in the treatment of non-traumatic headache in Emergency Departments.

Headache can be a symptom/complaint associated with many different types of conditions and diseases. Therefore, treatment for various types of non-traumatic headache can vary. 

Data marked for the years 2010 through 2018 were extracted from Cerner Health Facts© a large, validated and HIPAA compliant EHR data base. HF was searched using ICD 9 and 10 codes specific for diagnosis of non-traumatic headache. Patients were treated in an Emergency Department. Patient diagnosis, demographic information, pharmaceuticals prescribed and date of event were obtained. Data were cleaned and coded using SAS and SQL coding and methods and analyzed using SPSS v25.  Analgesics include acetaminophen, NSAIDs and aspirin.

We identified 5031 and 26916 adult patients from the years 2010 and 2018 respectively.  Overall, there was a decrease in the use of opioids from 46.9% of encounters in 2010 to 21% in 2018.  In 2010 there was no association between sex and opioid or analgesic use, but in 2018 females were 7.65% more likely to be prescribed an opioid whereas males were 12.4% more likely to be prescribed an analgesic. There was an association between race and being prescribed an opioid or analgesic in both years. In 2010, Caucasians were 2.27 times more likely to receive an opioid and Non-Caucasians were 1.2 times more likely to receive an analgesic. In 2018, Caucasians were 1.67 times more likely to receive an opioid and Non-Caucasians were 1.37 times more likely to receive an analgesic

The use of opioids in the ED to treat non-traumatic headaches decreased between 2010 and 2018. Opioid prescriptions vary by race and sex.  Over time, there has been a decrease in the difference in opioid prescriptions by race.