Clinical Implications of Opioid Use to Treat Cancer Related Pain
Sarah Shalan1, Laura Schienfeldt, PhD1
1Coriell Institute for Medical Research, Camden, NJ
The opioid epidemic is a serious national crisis that affects both public health and social and economic welfare. For decades, opioids have been prescribed for the treatment of acute and chronic pain, including chronic pain associated with cancer treatment. Long term opioid use for chronic pain treatment continues to be controversial. Concerns related to the effectiveness, safety, and risk of misuse persist. The risk benefit assessment of opioid use for cancer treatment related chronic pain is still unresolved; however, safe and effective cancer treatment related pain management is needed. In this analysis, we assessed two large-scale reports of SEER-medicare data collected from thousands of patients. The first study included tens of thousands of cancer patients (n=69,889) and matched controls (n=125,007), and the second study included over ten thousand (n= 10,773) breast cancer patients. Our literature review found that previous incidence of depression or substance abuse disorder increased the risk of developing opioid use disorder in cancer patients treated with opioids, and longer-term exposure to opioids during cancer treatment dramatically increased the risk of opioid use disorder in cancer patients treated with opioids. In addition, other negative outcomes, including treatment non-compliance must be considered when using opioids to treat cancer treatment related pain.
