Risk factors for opioid misuse in adolescents and young adults with focus on oncology setting

Peck, MA Kelly R.; Ehrentraut, Jennifer Harman; Anghelescu, Doralina L.

doi:10.5055/jom.2016.0333

Cited by 15 publications

(4 citation statements)

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“…Thanks to their pain relieving and sedative properties opioid medications may also produce feelings of pleasure, contentedness, and satisfaction, which may lead to misuse, abuse and addiction ( Pergolizzi et al, 2017 ). Young individuals are more at risk of inappropriate opioid use ( Peck et al, 2016 ). Misuse and addiction may lead to death by overdose.…”

Section: Introductionmentioning

confidence: 99%

Use of Psychotropic Medications and Illegal Drugs, and Related Consequences Among French Pharmacy Students – SCEP Study: A Nationwide Cross-Sectional Study

et al. 2018

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Background: The use of psychotropic medications and illegal drugs is a worldwide public health issue, leading to addiction, psychiatric and somatic disorders, and death. Pharmacy students are more exposed to psychotropic medications than other students (non-medical), which could lead to an overuse. The main objective of this study was to assess the prevalence of psychotropic drug use (medications and illegal drugs) by French pharmacy students, by carrying out a nationwide cross-sectional study. The relation of these medications and illegal drug use with several comorbidities and academic achievement was also assessed.Methods: This online survey was performed by emails sent to all French pharmacy faculties over a period of 66 days (March 16, 2016 to May 20, 2016). The survey assessed the prevalence of uses of psychotropic medications and illegal drugs during the last 3 months. These uses were compared to student characteristics (personal and university) and comorbidities (anxiety, depression, stress, and fatigue).Results: Of the 2,609 questionnaires received, 2,575 were completed and useable for the analysis. Among French pharmacy students and during the 3 last months, 9.4% have used psychotropic medications, 21.5% illegal drugs and 3.3% both psychotropic medications and illegal drugs. Psychotropic medications were used in the cases of a medical prescription (49.0%), a self-medication (42.4%) or a non-medical intent (26.3%). Stress scores of the last 7 days were higher for psychotropic medication users compared to non-users and illegal drug users. Proportions of anxiety and depression at the time of answer were higher for psychotropic medication users than for non-users and illegal drug users. Fatigue scores of the last 7 days were lower for illegal drug users compared to non-users and self-medicated students. Annual average marks of the last year, attendance and perception of study difficulty were lower for illegal drug users than for non-users.Conclusion: French pharmacy students were less exposed to psychotropic medications and illegal drugs than the general French population. However, in comparison to other students in other countries, the use of psychotropic medications seemed to be lower, but with a proportionally higher use of anxiety/sedative medications and a lower use of opioid medications.

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Section: Introductionmentioning

confidence: 99%

Use of Psychotropic Medications and Illegal Drugs, and Related Consequences Among French Pharmacy Students – SCEP Study: A Nationwide Cross-Sectional Study

et al. 2018

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“…In cancer patients, factors associated with PPA non-adherence were younger age, personal or familial mental health history, and history of illicit drug use [29,[33][34][35]. In patients with non-cancer chronic pain, factors associated with PPA nonadherence include active tobacco use, prior driving while intoxicated, drug-related offenses, being younger, and having an underlying psychiatric disorder [24,26,36,37]. This highlights the importance of identifying risk factors at baseline and providing risk stratification for monitoring.…”

Section: Discussionmentioning

confidence: 99%

Adherence to Opioid Patient Prescriber Agreements at a Safety Net Hospital

Pacheco

Nguyen

Halphen

et al. 2023

Cancers

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Patient prescriber agreements, also known as opioid contracts or opioid treatment agreements, have been recommended as a strategy for mitigating non-medical opioid use (NMOU). The purpose of our study was to characterize the proportion of patients with PPAs, the rate of non-adherence, and clinical predictors for PPA completion and non-adherence. This retrospective study covered consecutive cancer patients seen at a palliative care clinic at a safety net hospital between 1 September 2015 and 31 December 2019. We included patients 18 years or older with cancer diagnoses who received opioids. We collected patient characteristics at consultation and information regarding PPA. The primary purpose was to determine the frequency and predictors of patients with a PPA and non-adherence to PPAs. Descriptive statistics and multivariable logistic regression models were used for the analysis. The survey covered 905 patients having a mean age of 55 (range 18–93), of whom 474 (52%) were female, 423 (47%) were Hispanic, 603 (67%) were single, and 814 (90%) had advanced cancer. Of patients surveyed, 484 (54%) had a PPA, and 50 (10%) of these did not adhere to their PPA. In multivariable analysis, PPAs were associated with younger age (odds ratio [OR] 1.44; p = 0.02) and alcohol use (OR 1.72; p = 0.01). Non-adherence was associated with males (OR 3.66; p = 0.007), being single (OR 12.23; p = 0.003), tobacco (OR 3.34; p = 0.03) and alcohol use (OR 0.29; p = 0.02), contact with persons involved in criminal activity (OR 9.87; p < 0.001), use for non-malignant pain (OR 7.45; p = 0.006), and higher pain score (OR 1.2; p = 0.01). In summary, we found that PPA non-adherence occurred in a substantial minority of patients and was more likely in patients with known NMOU risk factors. These findings underscore the potential role of universal PPAs and systematic screening of NMOU risk factors to streamline care.

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“…Younger age and male sex are both risk factors for OUD but should not preclude leaving cancer pain untreated in pediatric patients, particularly boys (94). In a study of pediatric and young adult patients with cancer administered opioids for pain control (n = 94), aberrant drug-seeking behaviors occurred in 12% and of those patients, and 91% had at least one risk factor for substance use disorder.…”

Section: The Risk Of Oud In Special Populations Of Cancer Painmentioning

confidence: 99%

Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency

et al. 2021

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A clinical conundrum can occur when a patient with active opioid use disorder (OUD) or at elevated risk for the condition presents with cancer and related painful symptoms. Despite earlier beliefs that cancer patients were relatively unaffected by opioid misuse, it appears that cancer patients have similar risks as the general population for OUD but are more likely to need and take opioids. Treating such patients requires an individualized approach, informed consent, and a shared decision-making model. Tools exist to help stratify patients for risk of OUD. While improved clinician education in pain control is needed, patients too need to be better informed about the risks and benefits of opioids. Patients may fear pain more than OUD, but opioids are not always the most effective pain reliever for a given patient and some patients do not tolerate or want to take opioids. The association of OUD with mental health disorders (dual diagnosis) can also complicate delivery of care as patients with mental health issues may be less adherent to treatment and may use opioids for “chemical coping” as much as for pain control.

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Risk factors for opioid misuse in adolescents and young adults with focus on oncology setting

Cited by 15 publications

References 0 publications

Use of Psychotropic Medications and Illegal Drugs, and Related Consequences Among French Pharmacy Students – SCEP Study: A Nationwide Cross-Sectional Study

Use of Psychotropic Medications and Illegal Drugs, and Related Consequences Among French Pharmacy Students – SCEP Study: A Nationwide Cross-Sectional Study

Adherence to Opioid Patient Prescriber Agreements at a Safety Net Hospital

Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency

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