A new study found that opioid prescription use is more common in cancer survivors than in individuals without a history of cancer. This was true even among survivors who were ten or more years past their cancer diagnosis. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings come at a time of rising rates of opioid overdose and addiction that experts have categorized as an epidemic.
Little is known about prescribing opioids to relieve pain in individuals who have survived cancer. To investigate, Rinku Sutradhar, PhD, a senior scientist at the Institute for Clinical Evaluative Sciences in Toronto and an associate professor with the University of Toronto in Canada, and her colleagues analyzed information dating back to 2010 on 8601 adults at least five years past a cancer diagnosis who were matched with 8601 individuals without a prior cancer diagnosis based on sex and calendar year of birth. Follow-up was stopped at any indication of cancer recurrence, second malignancy, or new cancer diagnosis. The researchers looked for opioid prescriptions filled at a pharmacy during the observation period for each individual.
The rate of opioid prescribing was 1.22 times higher among survivors than corresponding matched controls. Over a 36-month period, the average number of opioid prescriptions filled by survivors was 7.7, compared with 6.3 for controls. This increased rate of opioid prescribing was also seen among survivors who were 10 or more years past their cancer diagnosis. Individuals with lower income, and those who were younger, from rural neighborhoods, and with more comorbidities had significantly higher prescribing rates. Sex was not associated with prescribing rates.
"Our research findings raise concerns about the diagnosis and management of chronic pain problems among survivors stemming from their cancer diagnosis or treatment," said Dr. Sutradhar. "Physicians providing primary care to cancer survivors should consider close examination of reasons for continued opioid use to differentiate chronic pain from dependency."
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Rinku Sutradhar et al, Cancer survivorship and opioid prescribing rates: A population-based matched cohort study among individuals with and without a history of cancer, Cancer (2017). DOI: 10.1002/cncr.30839