Social Habits, Cancer Type and Treatment Impact Increased Rates of Opioid Use

Patients who received chemotherapy, actively smoked and drank alcohol, and were diagnosed with head and neck cancer reported significantly higher rates of opiate use, according to study results presented at the American Society of Clinical Oncology (ASCO) 2018 Palliative and Supportive Care Symposium.

Moreover, the researchers found that 70 percent of patients with cancer used opiates after radiation, and survivors who were treated with radiation for more than four weeks had higher rates of opiate use just one year after finishing treatment.

Opioids are commonly prescribed for the management of moderate to severe chronic pain experienced by patients undergoing treatment for cancer, yet few statistics are available to assess how patients with cancer are affected by prescription opioid use. “We don’t know how many cancer patients died from prescription opiates and there is little published data about their prescribing patterns,” the researchers wrote.

To add to the body of knowledge around opioid use in patients with cancer, investigators from the University of Texas Southwestern Medical Center (UTSW) analyzed opioid prescription data from 6,424 patients with lung, breast and head and neck cancer to assess their demographics, cancer type, treatment modality, concurrent medicines, substance abuse history and survival.

The researchers saw widespread use among genders, with 76 percent of 2,112 men and 67 percent of 4,307 women who reported to use these medications, of which 8 percent had three or more different opiates prescribed. Hydrocodone was the most commonly used (67 percent), followed by morphine (12 percent), fentanyl (9 percent), oxycodone (7 percent), and hydromorphone (6 percent).

In total, 18.7 percent of women and 15.9 percent of men received gabapentin — a neuropathic pain reliever that is commonly prescribed to those addicted or at risk of addiction to opioids.

Of the 850 patients who received chemotherapy and radiation, 696 required opiates (82 percent) compared to 68 percent of those who did not receive chemotherapy. Patients with head and neck cancer reported the highest rate of opioid abuse (77 percent) compared with those with breast (65 percent) or lung cancer (70 percent).

Lastly, the researchers found that of the 2,643 patients who used alcohol, 2,001 received opiates (76 percent) compared to 67 percent of those who did not use alcohol. Among active smokers, 76 percent used opiates versus 67 percent of those who never smoked.