Long-Term Opioid Use in Post-Surgical Management of Patients With Head and Neck Cancer

Abstract

Objective: This study aims to identify clinical and socioeconomic factors associated with long-term, post-surgical opioid use in the head and neck cancer population. Methods: A single center retrospective study was conducted including patients diagnosed with head and neck cancer between January 1, 2014 and July 1, 2019 who underwent primary surgical management. The primary outcome measure was continued opioid use 6 months after treatment completion. Both demographic and cancer-related variables were recorded to determine what factors were associated with prolonged opioid use. Univariate analysis was performed using chi-squared test for categorical variables and 2-sample t-test for continuous variables. Multivariate analysis was performed using logistic regression. Results: A total of 359 patients received primary surgical management. Forty-five patients (12.53%) continued to take opioids 6 months after treatment completion. Using univariate analysis, patients less than 65 years of age ( P = .0126), adjuvant chemoradiation (n = 25, P < .001), and overall length of hospital stay (8.60 ± 8.58 days, P = .0274) were significantly associated with long term opioid use. Multivariate logistic regression showed that adjuvant chemoradiation (OR = 3.446, 95% CI [1.742, 6.820], P = .0004) and overall length of hospital stay (OR = 0.949, 95% CI [0.903, 0.997], P = .0373) to be significantly associated with opioid use 6 months after head and neck cancer treatment. Conclusion: Long-term postoperative opioid use in head and neck cancer patients is significantly associated with adjuvant chemoradiation, and patients with longer length of hospital stay. Therefore, future research should focus on interventions to better manage opioid use during the acute treatment period to decrease long-term use.

Association of a Multimodal Intervention With Decreased Opioid Prescribing After Neck Dissection for Malignant Thyroid Disease With Short Hospital Stay

“…[14][15][16][17][18] Studies have documented the dangers of overprescribing and long-term opioid abuse. [19][20][21][22] More than 70% of postoperative opioid prescriptions are unused and are subsequently stored in unlocked locations in as many as 77% of cases. 23,24 These excess opioids are at high risk for diversion to nonmedical opioid use.…”

“…Previous studies have reported a wide range of pain levels and medication requirements associated with head and neck oncologic surgical procedures . Studies have documented the dangers of overprescribing and long-term opioid abuse . More than 70% of postoperative opioid prescriptions are unused and are subsequently stored in unlocked locations in as many as 77% of cases .…”