Risk Factors for Opioid Misuse Among Patients With Cancer

Opioid misuse is a major public health concern. Because many patients with cancer rely on pain medication to manage cancer symptoms, there is a risk for opioid dependence in this population. To clarify the risk of opioid dependence among patients with cancer, a recent study evaluated common factors associated with opioid misuse among 106,732 cancer survivors treated from 2000 to 2015 from the Veterans Affairs Informatics and Computing Infrastructure.

The study found that persistent post-cancer treatment opioid use, defined as having filled 120 or more days’ supply or 10 or more opioid prescriptions from 1 to 2 years following the initiation of curative treatment, occurred in 8.3% of patients, but this varied widely by cancer type. Lowest rates were observed among patients with prostate cancer (5.3%), while highest rates of opioid use were seen in patients with liver cancer (19.8%). A total of 2.9% of patients were identified as engaging in opioid abuse or dependence, and 2.1% of patients required hospital admission due to opioids.

History of opioid use was also associated with an increase in chronic post-treatment opioid use, with 72.2% of patients with a history of chronic opioid use engaging in persistent post-cancer opioid use. Among patients with no prior history of opioid use, only 3.5% had persistent post-cancer opioid use. Opioid-naïve patients who received opioids during the diagnostic and treatment period were more likely to have chronic post-treatment opioid use than those who did not receive opioids during this time period (6.2% vs 1.5%). Additional risk factors associated with chronic post-cancer treatment opioid use included younger age, white race, unemployment, lower median income, tobacco use, previous diagnosis of alcohol or non-opioid drug abuse, and depression.

The investigators concluded that these results identify several key factors associated with increased risk for opioid dependence among patients with cancer and may be used to create clinical tools to help pre-screen patients for referral to pain specialists.

Read more about this study on Medscape Medical News.

J Natl Cancer Inst. 2019 Nov 23. [Epub ahead of print.]

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