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Review
. 2021 Nov 16:2:691720.
doi: 10.3389/fpain.2021.691720. eCollection 2021.

Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency

Joseph V Pergolizzi Jr  1 , Peter Magnusson  2   3 , Paul J Christo  4 , Jo Ann LeQuang  1 , Frank Breve  5 , Kailyn Mitchell  1 , Giustino Varrassi  6
Affiliations
Review

Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency

Joseph V Pergolizzi Jr et al. Front Pain Res (Lausanne). .

Abstract

A clinical conundrum can occur when a patient with active opioid use disorder (OUD) or at elevated risk for the condition presents with cancer and related painful symptoms. Despite earlier beliefs that cancer patients were relatively unaffected by opioid misuse, it appears that cancer patients have similar risks as the general population for OUD but are more likely to need and take opioids. Treating such patients requires an individualized approach, informed consent, and a shared decision-making model. Tools exist to help stratify patients for risk of OUD. While improved clinician education in pain control is needed, patients too need to be better informed about the risks and benefits of opioids. Patients may fear pain more than OUD, but opioids are not always the most effective pain reliever for a given patient and some patients do not tolerate or want to take opioids. The association of OUD with mental health disorders (dual diagnosis) can also complicate delivery of care as patients with mental health issues may be less adherent to treatment and may use opioids for "chemical coping" as much as for pain control.

Keywords: cancer; cancer pain; opioid; opioid agonist therapy; opioid dependency; opioid use disorder; pain.

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Conflict of interest statement

JP and KM were employed by company NEMA Research, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. van den Beuken-van Everdingen MHJ, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J. High prevalence of pain in patients with cancer in a large population-based study in the Netherlands. Pain. (2007) 132:312–20. 10.1016/j.pain.2007.08.022 - DOI - PubMed
    1. Deandrea S, Montanari M, Moja L, Apolone G. Prevalence of undertreatment in cancer pain. A review of published literature. Ann Oncol. (2008) 19:1985–91. 10.1093/annonc/mdn419 - DOI - PMC - PubMed
    1. Portenoy RK, Ahmed E. Cancer pain syndromes. Hematol Oncol Clin North Am. (2018) 32:371–86. 10.1016/j.hoc.2018.01.002 - DOI - PubMed
    1. Glare PA, Davies PS, Finlay E, Gulati A, Lemanne D, Moryl N, et al. Pain in cancer survivors. J Clin Oncol. (2014) 32:1739–47. 10.1200/JCO.2013.52.4629 - DOI - PMC - PubMed
    1. American Cancer Society . Cancer Treatment & Survivorship: Facts and Figures 2019-2021. (2021). Available online at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-... (accessed February 23, 2021)

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