Opioids in Cancer Pain: Right or Privilege?

Jackson, Leanne K.; Imam, Syed N.; Braun, Ursula K.

doi:10.1200/jop.2016.019216

Cited by 6 publications

(3 citation statements)

References 20 publications

(24 reference statements)

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“…In addition, the incidence of persistent opioid use varied significantly across surgery types (p < 0.001) and cancer stage (p = 0.004) with higher rates observed among patients who underwent colorectal surgery, and in those with stage 3 cancer. Furthermore, higher rates of persistent opioid use were observed among patients with longer anesthesia duration (median [IQR] 7 hr [5][6][7][8][9] versus 6 hr [4][5][6][7][8]; p = 0.007), and in those who received more opioids intraoperatively (median [IQR] 34 MEDD versus 30 MEDD ; p = 0.016).…”

Section: Effects Of Other Potentially Confounding Factorsmentioning

confidence: 99%

“…4 Despite the availability of analgesic options, opioids have remained a cornerstone for the treatment of moderate-tosevere pain in cancer patients. 5 However, opioid-related adverse effects have been shown to negatively impact the quality of life of cancer patients and survivors. 6 Particularly concerning is the development of persistent or chronic opioid use, which may not only prolong the disabling adverse effects of opioids but also increase the risk of death related to overdose.…”

Section: Introductionmentioning

confidence: 99%

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Race, Ethnicity, and Sustained Opioid Use After Major Abdominal Surgery for Cancer

Owusu-Agyemang,

Feng,

Cata

2023

JPR

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Sustained opioid use is a well-known complication after surgery. Our objective was to determine whether there is any association between a patient's race or ethnicity and the sustained use of opioids in the year following surgery. Opioid use over the initial 3, 6, and 12 postoperative months was categorized as "sustained early", persistent, and chronic, respectively. Patients and Methods: Single-institution retrospective study of adults (≥18 years) who had undergone open abdominal surgery for cancer. Multivariable logistic regression was used to evaluate the association between race/ethnicity and opioid use. Results: Of the 3523 patients included in the study, 2543 (72.2%) were non-Hispanic (NH) White, 476 (13.5%) were Hispanic or Latino, 262 (7.4%) were NH-Black, 186 (5.3%) were Asian, and 56 (1.6%) belonged to other racial or ethnic groups. The overall rates of sustained early, persistent, and chronic opioid use were 15.9%, 7.1%, and 2.6%, respectively. In the multivariable analysis, patient race/ethnicity was associated with sustained early postoperative opioid use (p-value=0.037), with Hispanics/Latinos having significantly higher odds than NH-Whites (OR = 1.382 [95% CI: 1.057-1.808]; p = 0.018). However, neither persistent nor chronic opioid use was associated with race/ethnicity (p = 0.697 and p = 0.443, respectively). Conclusion:In this retrospective study of adults who had undergone open abdominal surgery, patient race/ethnicity was not consistently associated with the development of sustained opioid use over the first 12 postoperative months.

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Section: Effects Of Other Potentially Confounding Factorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Race, Ethnicity, and Sustained Opioid Use After Major Abdominal Surgery for Cancer

Owusu-Agyemang,

Feng,

Cata

2023

JPR

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“…25,26 There are times when OUD is so severe that even with multiple safeguards in place, it is deemed too dangerous to treat cancer pain with opioid medications. 27 Ideally, oncologists and their patients would have access to experts such as addiction medicine, pain and palliative care specialists, as well as mental health providers with additional training in the complexities of addiction to safely navigate this tight rope. However, access to addiction medicine specialist is poor nationwide, significantly more so in rural communities.…”

Section: Nonmaleficencementioning

confidence: 99%

When Management of Cancer-Related Pain Is Complicated by Coexisting Opioid Use Disorder

Lowry¹

2022

J Hosp Palliat Nurs

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Patients with cancer are living longer, and many experience pain secondary to tumor invasion or as a consequence of cancer-directed therapies. Opioid use disorders and associated morbidity and mortality have increased with dramatic rise during the SARS-CoV-2 pandemic. National and international stakeholders have developed clinical practice guidelines in an effort to curb opioid misuse and overdose-related death. However, to ensure that patients with cancer do not experience barriers to adequate pain management, most of these guidelines are not intended for patients with cancer-related pain or for those receiving palliative or hospice care. Oncology, palliative, and hospice care providers are increasingly tasked with the management of severe disease-related pain in the setting of coexisting opioid use disorder without research on the most effective risk and harm reduction strategies to guide care.Clinicians should be familiar with addiction medicine and chronic pain literature and be able to incorporate some of these best practices. This case study reviews the management of severe cancer-related pain in a patient with co-occurring opioid use disorder, utilizing many of the best practices in available clinical practice guidelines for the management of chronic non–cancer-related pain.

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2017

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Opioids in Cancer Pain: Right or Privilege?

Cited by 6 publications

References 20 publications

Race, Ethnicity, and Sustained Opioid Use After Major Abdominal Surgery for Cancer

Race, Ethnicity, and Sustained Opioid Use After Major Abdominal Surgery for Cancer

When Management of Cancer-Related Pain Is Complicated by Coexisting Opioid Use Disorder

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