Black children with acute appendicitis — a clearly painful emergency — are less likely than white children to get painkillers in the emergency room, researchers reported Monday.

And nearly as troubling, only about half of any of the kids got painkillers, even though they're strongly recommended in cases of appendicitis, the researchers found.

"Black patients with moderate pain were less likely to receive any analgesia, and black patients with severe pain were less likely to be treated with opioids," Dr. Monika Goyal of the Children's National Health System in Washington and colleagues wrote in the Journal of the American Medical Association's JAMA Pediatrics.

What's to blame? Probably a combination of an unwarranted fear of opioids such as morphine and fentanyl, combined with unconscious bias against African-American kids, experts said.