New Persistent Opioid Use Among Patients With Cancer After Curative-Intent Surgery
Lee JS, Hu HM, Edelman AL, et al J Clin Oncol. 2017;35:4042-4049
Study Summary
Patients with cancer undergoing curative-intent therapies may be vulnerable to opioid misuse or dependence because of many reasons, including postoperative pain, psychological distress, pain from adjuvant therapies, and uncoordinated prescribing from multiple providers.
Lee and colleagues sought to define the risk for new persistent opioid use after curative-intent surgery in patients with melanoma, breast, colorectal, lung, esophageal, and hepato-pancreato-biliary/gastric cancers treated with curative surgery between 2010 and 2014.
Using a national data set of insurance claims, they identified more than 68,000 patients, of whom approximately 40,000 were opioid naive, 16,000 were intermittent opioid users, and 12,000 were chronic opioid users prior to surgery.
Among opioid-naive patients, the risk for new persistent opioid use was 10%. One year after surgery, these patients continued filling prescriptions with daily doses similar to those of chronic opioid users, equivalent to 6 tabs per day of 5 mg of hydrocodone. Those receiving adjuvant chemotherapy had modestly higher doses; the covariate-adjusted risk for new persistent opioid use in patients receiving adjuvant chemotherapy was 15%-21% compared with 7%-11% for those who did not receive chemotherapy.
