(HealthDay News) — Experts have recommended that, for patients with cancer-related pain who are using nonmedical stimulants, opioids should be continued, monitoring should be increased, and tapering should be avoided. These recommendations were published in Cancer.

Researchers sought to determine expert consensus on opioid management strategies for a patient with advanced cancer and cancer-related pain who is using nonmedical stimulants, depending on the patient’s prognosis.

The researchers conducted 2 modified Delphi panels with 120 palliative care and addiction experts. The patient’s prognosis was weeks to months in panel A and months to years in panel B. A 3-step analytical approach was applied to determine consensus and levels of clinical appropriateness for the management strategies.

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For all management strategies, consensus was achieved. The experts deemed it appropriate to continue opioids, increase monitoring, and avoid opioid tapering for the patient, regardless of prognosis.

The experts deemed buprenorphine/naloxone transition inappropriate for a patient with a short prognosis. For a patient with a longer prognosis, the appropriateness of buprenorphine/naloxone transition was uncertain.

“The study findings provide consensus-based guidance for clinicians who treat cancer-related pain and encounter stimulant use, and include management strategies they can bring immediately to their practice,” study author Katie Fitzgerald Jones, PhD, from the VA Boston Healthcare System, said in a statement. “The results highlight a need for integrated care models to address substance use during cancer and create a research agenda that prioritizes substance use disorder as an important comorbidity in people with cancer.”

Several study authors disclosed ties to industry.

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