Study: Cancer Survivors Have Higher Rates of Prescription Opioid Use, but Similar Rates of Opioid Misuse Compared to Individuals Without Cancer

A new study suggests cancer survivors have higher rates of opioid use compared to people without cancer, but this finding may not translate to increased opioid misuse among the population. The study appeared on August 17 in JAMA Network Open.

“Prescription opioids are frequently prescribed to treat cancer-related pain. However, limited information exists regarding rates of prescription opioid use and misuse in populations with cancer,” the research authors wrote in their abstract.

In this retrospective, cross-sectional study, researchers analyzed responses from 169,162 participants  (18 years or older) of the National Survey on Drug Use and Health from January 2015 to December 2018. Subsequently, all participants with a reported history of cancer were termed cancer survivors and allocated into two groups (had cancer within 12 months of survey) and less recent (had cancer more than 12 months prior to survey) cohorts. The main outcome was defined as prescription opioid use and misuse within the past 12 months. All rspondents with nonmelanoma skin cancer were excluded from the study.

According to the results of the study, prescription opioid use was higher among more recent cancer survivors (54.3%; 95% CI, 50.2% to 58.4%; odds ratio [OR]=1.86; 95% CI, 1.57 to 2.20; P<.001) and less recent cancer survivors (39.2%=95% CI, 37.3% to 41.2%; OR=1.18; 95% CI, 1.08 to 1.28; P < .001) compared with respondents without cancer (30.5%, reference group).

However, the researchers observed similar rates of prescription opioid misuse among more recent (3.5%; 95% CI, 2.4%-5.2%; OR, 1.27; 95% CI, 0.82 to 1.96; P = .36) and less recent (3.0%; 95% CI, 2.4%-3.6%; OR, 1.03; 95% CI, 0.83 to 1.28; P=.76) survivors juxtaposed to respondents without cancer (4.3%, reference group).

Factors that associated with opioid misuse among cancer survivors included younger age (aged 18-34 years vs ≥65 years: OR=7.06; 95% CI, 3.03 to 16.41; P < .001), alcohol use disorder (OR=3.22; 95% CI, 1.45 to 7.14; P = .005), and nonopioid drug use disorder (OR= 14.76; 95% CI, 7.40 to 29.44; P < .001).

“These findings suggest that increased prescription opioid use among cancer survivors does not necessarily translate to a higher risk of misuse,” the researchers wrote in conclusion.

Survey study finds cancer survivors have higher rates of prescription opioid use, but similar rates of misuse, compared to non-cancer respondents; higher opioid use does not translate to higher misuse in the cancer population https://t.co/U6yupE69lX

— JAMA Network Open (@JAMANetworkOpen) August 17, 2020

The researchers added it is “imperative that opioid legislation and policies recognize that cancer survivors will have a higher rate of prescription opioid use and that restrictions on prescription opioid access for cancer survivors are incongruent with their opioid utilization patterns. Our analysis supports continued access to opioid medications for cancer survivors who may benefit from such therapy.”