Curative-intent Surgery for Cancer Increases Risk of New Persistent Opioid-use
The modern opioid epidemic is forcing health care providers and government agencies to reevaluate pain management, but there is a lack of data regarding the risk of opioid-misuse among vulnerable popu
Patients with cancer who undergo curative-intent surgery for cancer are at risk of iatrogenic new persistent opioid-use, according to a study published in the Journal of Clinical Oncology.1
The modern opioid epidemic is forcing health care providers and government agencies to reevaluate pain management, but there is a lack of data regarding the risk of opioid-misuse among vulnerable populations.
For this retrospective study, researchers accessed a market research database of insurance claims to review the data of 68,463 patients with cancer who underwent curative-intent surgery and filled an opioid prescription between 2010 and 2014.
First-time opioid users had a 10.4% (95% CI, 10.1%-10.7%) risk of persistent opioid use, and even after 1 year of surgery, patients continued to take opioids at dosages similar to those of chronic opioid users (P = .05), which is approximately a total daily dose of hydrocodone 30 mg.
Patients who received adjuvant chemotherapy took opioids at increased doses (P = .002), but even patients who did not undergo chemotherapy took doses of opioids similar to chronic opioid users.
Multivariate analysis of curative-intent procedures revealed that the persistent new opioid-use risk among patients who received adjuvant chemotherapy was 15% to 21%, while the risk for patients who do not receive chemotherapy was 7% to 11%.
The authors concluded that this “problem requires changes to prescribing guidelines and patient counseling during surveillance and survivorship phases of care.”
- Lee JS, Hu HM, Edelman AL, et al. New persistent opioid use among patients with cancer after curative-intent surgery. J Clin Oncol. 2017 Oct 19. doi: 10.1200/JCO.2017.74 [Epub ahead of print]