What are recent trends in opioid prescribing for patients with cancer?
A recent analysis reveals a modest decline from 2016 to 2020 in new and additional opioid prescriptions for patients with cancer. Among those patients with metastatic cancer, prescribing remained stable for those reporting any pain and declined steeply for those reporting no pain. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.
In response to the opioid crisis, public health efforts have sought to enact policies and regulations to reduce inappropriate opioid prescribing and prevent unsafe opioid use, including adverse outcomes such as opioid use disorder and opioid overdose. However, such efforts could unintentionally reduce access to opioids for patients with cancer, leading to under-treatment of cancer-related pain.
To assess trends in opioid prescribing for patients with cancer, investigators analyzed data on adults who had not previously been prescribed opioids and were newly diagnosed with cancer in 2016–2020 in a large Connecticut health system. New opioid prescriptions were defined as those given in the first 6 months following diagnosis, and additional prescriptions were defined as those given in the first 6 months following diagnosis and in months 7–9 after diagnosis.
In the study of 10,232 patients, there was a decline in new (71.1% to 64.6%) and additional (27.2% to 24.2%) prescribing from 2016 to 2020. Among patients who underwent cancer surgery, new opioid prescribing fell from 96.0% to 88.6%, while additional prescribing was stable at 13%. For patients with metastatic cancer, new prescribing was stable at 56% for those who reported pain and declined from 61.6% to 36.1% for those reporting no pain.
“The treatment of cancer-related pain in the setting of the ongoing opioid epidemic is complicated. Reassuringly, our study shows that declines in opioid prescribing for patients with cancer appear to reflect clinical judgment and context,” said lead author Laura Van Metre Baum, MD, MPH, of Yale School of Medicine at the time of the study, now of Dana-Farber Cancer Institute. “Important questions remain regarding how to best ensure adequate treatment of cancer pain for all patients.”
Reference:
Laura Van Metre Baum , Pamela R. Soulos , Madhav KC, Molly M. Jeffery, Kathryn J. Ruddy, Catherine C. Lerro, Opioid prescribing trends and pain scores among adult patients with cancer in a large health system, Cancer, https://doi.org/10.1002/cncr.70027
