Louisiana Via Research Day Book 2026

Community / Public Health

Community / Public Health

120 POST-INSERTION PAIN CONTROL AFTER INTRAUTERINE DEVICE (IUD) PLACEMENT: RACIAL AND SOCIOECONOMIC TRENDS IN OPIOID PRESCRIBING PATTERNS

121 BY WHOSE AUTHORITY? LEGAL VARIABILITY IN CONTROL AND DISPOSITION OF UNCLAIMED HUMAN REMAINS IN THE UNITED STATES

Shelda St. Preux, MS; Thashanna Lyle, BS; Sydni Kynard, MS; Lin Kang, PhD; Savannah Newell, PhD VCOM-Louisiana

Caitlin Canova, OMS-II; Savannah Newell, PhD; Kristina Kellogg, OMS-II; Emma Howell, OMS-II; Saad Ali, OMS-II VCOM-Louisiana

Context: Pain during intrauterine device (IUD) insertion can act as a barrier to its use, particularly among women of different racial and socioeconomic backgrounds. Although IUDs are among the most effective forms of contraception, pain management practices during insertion vary widely, and patient pain may be underestimated by providers performing the procedure. Historical evidence demonstrates that Black patients are often undertreated for pain due to implicit bias and structural inequities, yet little is known about whether these disparities extend to reproductive procedures. Objective: The purpose of this study was to examine whether racial and socioeconomic disparities exist in opioid prescribing patterns for pain management following IUD insertion. We hypothesized that Black women undergoing IUD insertion would receive fewer opioid prescriptions for pain management compared to white women, reflecting historical patterns of undertreatment. Additionally, we hypothesized that women of lower socioeconomic status (SES) would receive opioids at lower rates than women of higher SES.

Methods: A retrospective cohort study was conducted using data from the All of Us Research Program, analyzing 12,586 IUD insertion procedures across 6,259 individual patients from 2005 onward. The association between race, socioeconomic status, and receipt of an opioid prescription following IUD insertion was assessed using a binomial logistic regression model to estimate odds ratios. Multivariable adjustments were made for age, median household income, and neighborhood-level factors. Results: Over 80% of IUD insertion procedures were not associated with any prescription pain medication, while approximately 4% resulted in an opioid prescription. Opioid prescribing increased modestly over time (OR = 1.05 per year). Black patients were significantly more likely than white patients to receive an opioid prescription following IUD insertion (OR = 4.59), and this association persisted after multivariable adjustment. Median household income was also significantly associated with opioid prescribing, with both the lowest and highest income groups demonstrating higher prescription rates compared to middle-income groups, though the effect size was small.

Conclusion: Contrary to expectations based on prior literature, Black women in this cohort appeared to be more likely to receive opioid prescriptions following IUD insertion. Collectively, these findings suggest that pain management patterns in reproductive healthcare may differ from established trends observed in other clinical contexts. Possible explanations include evolving provider awareness of racial disparities, patient advocacy, or overcorrection in pain treatment practices. Further research is needed to examine clinical decision-making, patient-reported pain, and non-opioid pain management strategies to better understand equity in reproductive healthcare delivery.

Background: While variability in consent documentation for whole-body donation programs has been well documented, the legal mechanisms that determine control of human remains when donor consent or next of kin are absent have been less thoroughly examined. This study conducted a systematic review of statutes from all 50 U.S. states and six territories to evaluate how authority over a decedent’s remains is assigned when familial priority is no longer applicable. Statutes related to the transfer of custodial control, classification of bodies as unclaimed, involvement of coroners or medical examiners, existence of anatomical or anatomy boards, and permitted uses of remains were analyzed. In 44 of 56 jurisdictions (78.6%), coroners or medical examiners serve as the primary custodial authority when no next of kin is available. Anatomical or anatomy boards with statutory authority over unclaimed bodies were found in 19 jurisdictions (33.9%), while others delegate responsibility to county governments, welfare agencies, or health departments. Mandatory waiting periods before educational or scientific use varied, with 27 jurisdictions (48.2%) specifying durations ranging from 24 hours to 90 days; the remaining 29 (51.8%)

relied on non-specific standards, often requiring only “reasonable efforts” to locate family. The use of unclaimed remains for education or science is explicitly permitted in 52 jurisdictions (92.9%), but only 21 (37.5%) clearly identify eligible institutions. Regarding transport or redistribution, 15 jurisdictions (26.8%) have explicit statutory provisions, whereas 41 (73.2%) leave such decisions to institutional discretion or omit them. Territorial laws generally emphasize public health-oriented disposition over anatomical education, with five of six territories (83.3%) adopting this approach. These findings reveal significant legal heterogeneity and ambiguity surrounding unclaimed human remains. The inconsistent definitions, timelines, and limitations impact donor autonomy, institutional accountability, and public trust. Clearer, more standardized legislation could enhance ethical management, reinforce consent boundaries, and better align legal authority with donor expectations.

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2026 Research Recognition Day