Compared with individuals without cancer, adult cancer survivors had higher rates of prescription opioid use, according to a study published in JAMA Network Open. The investigators of the study also noted that opioid use among patients with cancer did not directly lead to an increase in opioid misuse.
In a retrospective, population-based, cross-sectional study, a team of investigators aimed to determine the trends in prescription opioid use among adult cancer survivors compared with individuals without cancer. The main outcome of the study measured opioid use and misuse within the past 12 months of the analysis.
Of the 169,162 individuals who were assessed, 5.2% were cancer survivors (5139 patients): 1.2% (1243 patients) reported having recent cancer histories, while 4.0% (3896 patients) reported having less recent cancer histories.
Compared with respondents without cancer who used opioids (30.5%), the prevalence of use was higher among both less and more recent cancer survivors (39.2% and 54.3%, respectively; P <.001 for both groups).
In addition, both less and more recent cancer survivor groups had similar rates of prescription misuse compared with respondents without cancer (4.3%). Among patients with more recent cancer, the prescription opioid misuse rate was 3.5% compared with 3.0% in patients with less recent cancer.
The investigators also noted that a higher prevalence of opioid misuse among cancer survivors was associated with a younger age (aged 18-34 years vs ≥65 years; odds ratio [OR], 7.06; P <.001), alcohol use disorder (OR, 3.22; P =.005), and nonopioid drug use disorder (OR, 14.76; P <.001).
One limitation that the authors noted was the nature of the self-reporting process. “[R]espondents may have limited ability or be unwilling to accurately self-report opioid misuse, resulting in the risk of [underreporting] in the survey,” the authors noted.
“It is imperative that opioid legislation and policies recognize that cancer survivors will have a higher rate of prescription opioid use and that restrictions on prescription opioid access for cancer survivors are incongruent with their opioid utilization patterns. Our analysis supports continued access to opioid medications for cancer survivors who may benefit from such therapy,” the investigators concluded.
Jairam V, Yang DX, Verma V, Yu JB, Park HS. National patterns in prescription opioid use and misuse among cancer survivors in the United States. JAMA Netw Open. Published online August 17, 2020. 2020;3(8):e2013605. doi:10.1001/jamanetworkopen.2020.13605