JAMA Oncology: Frequency and influence of opioid use in cancer patients

Cancer pain, alias cancer pain, advanced cancer pain, is one of the main causes of pain in patients with advanced cancer.
is the sensation caused when information about the pain area that needs to be repaired or regulated is transmitted to the nerve center.
in patients with pain, 50% to 80% of cancer pain is not effectively controlled for various reasons.
causes of cancer pain can be divided into three categories: (1) pain caused directly by tumors, about 88% ;(2) pain caused by cancer treatment, about 11% ;(3) indirect pain caused by tumors, about 1%.
and if you ask, how painful is the cancer pain? Then the answer may be that people who have never been in pain never know.
Opioids are widely used to treat pain in cancer patients because they are safe, have multiple routes of administration, are easy to dose titration, are reliable, and are effective for all types of pain (i.e., somatic, visceral, and neuropathic pain).
that while neuropathic pain may be more difficult to treat, the use of opioid-based analgesic therapy often yields better results.
the possibility of drug abuse in opioids.
the adverse public health consequences of opioid abuse, it is important to ensure that all physicians are responsible for risk management when they issue opioids for legitimate medical purposes.
is there a way to predict non-medical opioid use (NMOU) behavior, or opioid abuse, in cancer patients? To this end, experts from the University of Texas in the United States conducted related research.
results were published in the latest JAMA sub-journal, JAMA Oncology.
the purpose of this prognosmation study is to determine the overall frequency of NMOU behavior and independent predictive factors to better guide the application of NMOU.
from March 18, 2016 to June 6, 2018, 3,615 cancer patients were referred to the Support Care Center at the University of Texas Anderson Cancer Center, one of the world's largest cancer centers.
include patients with cancer who have been on opioid medication for cancer pain for at least 1 week.
a total of 1,554 patients who followed them continuously were evaluated for NMOU behavior using established diagnostic criteria.
all patients were evaluated using the Edmonton Symptom Assessment Scale, the Filters for Pain Patients, and the Opioid Assessment (SOAPP), as well as the Cut Down, Annoyed, Guilty, Eye Opener-Adapted to Include Drugs (CAGE-AID) survey.
study of patients who took opioids to treat cancer pain found that 19 percent of patients experienced NMOU behavior within 8 weeks of the mid-term duration of their initial supportive care outpatient visit.
1,554 patients, 299 (19.2%) had one or more NMOU behaviors, with a median NMOU behavior of 1 per patient.
576 (77%) of the 745 NMOU behaviors in the first two follow-up visits occurred.
, the most common NMOU behavior was to see a doctor for improper drug renewal (218/745, 29%).
88 (29.4%) of the 99 patients scored ≥7,48 (16.6%) in the CAGE-AID survey ≥2.
results of the multivariable model showed that marital status (single, HR=1.58; divorce, HR=1.43), SOAPP score (positive and negative, HR=1.35), morphine daily dose (MEDD) (HR=1.003) and Edmonton symptom assessment scale pain level (HR=1.11) were independently associated with the presence of NMOU behavior.
further analysis, singles, MEDD greater than 50mg, and SOAPP scores greater than 7 were associated with a higher risk (56%) of NMOU behavior.
, the study found that marital status (single or divorced), SOAPP scores greater than 7, higher pain severity, and MEDD levels were independently associated with NMOU behavior, suggesting that particular attention needed to be paid to opioid use in such populations.
reference: Yennurajalingam S, et al. Frequency of and Factors Associated With Nonmedical Opioid Use Behavior Among Patients With Cancer Receiving Opioids for Cancer Pain. JAMA Oncol. 2021 Jan 7. doi: 10.1001/jamaoncol.2020.6789.MedSci Original Source: MedSci Original Copyright Notice: All notes on this website "Source: Met Medical" or "Source: MedSci Original" text, images and audio-visual materials, copyrights are owned by Metz Medicine, without authorization, no media, website or individual may reproduce, authorized to reproduce with the words "Source: Mets Medicine".
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