Provision of Adequate Pain Management to a Young Adult Oncology Patient Presenting with Aberrant Opioid-Associated Behavior: A Case Study

Abstract

Pain and emotional distress are relevant risk factors as clinicians assess for aberrant opioid-associated behavior and provide adequate and responsible pain relief to patients who engage in behaviors that may be interpreted as drug seeking in nature. The present case illustrates how undertreated pain and treatment-related anxiety affected the opioid use of a young adult with cancer. Because these risk factors were identified during the initial consult, the treatment team was able to implement a multimodal and multidisciplinary treatment approach that provided the patient with better analgesia and coping skills for anxiety.

Assessment tools for problematic opioid use in palliative care: A scoping review

“…We identified two types of tools used to assess for problematic opioid use in palliative care: questionnaires ( n = 32, 76%) 53–55,57,58,61–63,65,66,68–89 and urine drug tests ( n = 21, 50%), 17,53,55,56,57,59,60,63,64,67,68,70,71,81,82,85,89–93 with an overlap of both types in 11 studies (26%). 53,55,57,63,68,70,71,81,82,85,89 Two studies did not specify which questionnaire they used.…”

“…Most studies ( n = 30, 94%) were conducted in outpatient clinics 53–55,57,58,61–63,65,66,68–79,81–83,85–89 and in the US ( n = 28, 88%), 53–55,57,58,61,62,63,65,66,69–79,81–83,85–87,89 and published between 2009 and 2020. The same tertiary cancer center conducted many of the studies ( n = 16, 50%): CAGE ( n = 7, 44%), 74–80 CAGE-AID ( n = 6, 37.5%), 62,81…”

“…Most studies (n = 30, 94%) were conducted in outpatient clinics [53][54][55]57,58,[61][62][63]65,66,[68][69][70][71][72][73][74][75][76][77][78][79][81][82][83][85][86][87][88][89] and in the US (n = 28, 88%), [53][54][55]57,58,61,62,63,65,66,[69][70][71][72][73][74][75][76][77][78][79][81]…”

Children's cancer pain in a world of the opioid epidemic: Challenges and opportunities

“…However, given data suggesting potential for opioid misuse, particularly within the adolescent and young adult (AYA) oncology population, risk factors associated with opioid misuse have begun to be examined. Research in this area suggests that multidisciplinary care of AYA oncology patients is extremely important given the potential for psychiatric distress in this population that may place AYA patients at greater risk for misuse of opioids . In addition, history of substance use among patients, peers, and family is a risk factor for opioid misuse …”

“…Research in this area suggests that multidisciplinary care of AYA oncology patients is extremely important given the potential for psychiatric distress in this population that may place AYA patients at greater risk for misuse of opioids. 40,41 In addition, history of substance use among patients, peers, and family is a risk factor for opioid misuse. 40…”