Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency
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...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-11-01
|
| Series: | Frontiers in Pain Research |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpain.2021.691720/full |
| _version_ | 1818837703445184512 |
|---|---|
| author | Joseph V. Pergolizzi Peter Magnusson Peter Magnusson Paul J. Christo Jo Ann LeQuang Frank Breve Kailyn Mitchell Giustino Varrassi |
| author_facet | Joseph V. Pergolizzi Peter Magnusson Peter Magnusson Paul J. Christo Jo Ann LeQuang Frank Breve Kailyn Mitchell Giustino Varrassi |
| author_sort | Joseph V. Pergolizzi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T03:26:43Z |
| format | Article |
| id | doaj.art-d8aa530fb1c442bfb61e322a5a85994a |
| institution | Directory Open Access Journal |
| issn | 2673-561X |
| language | English |
| last_indexed | 2024-12-19T03:26:43Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pain Research |
| spelling | doaj.art-d8aa530fb1c442bfb61e322a5a85994a2022-12-21T20:37:35ZengFrontiers Media S.A.Frontiers in Pain Research2673-561X2021-11-01210.3389/fpain.2021.691720691720Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex DependencyJoseph V. Pergolizzi0Peter Magnusson1Peter Magnusson2Paul J. Christo3Jo Ann LeQuang4Frank Breve5Kailyn Mitchell6Giustino Varrassi7NEMA Research, Inc., Naples, FL, United StatesCentre for Research & Development, Uppsala University, Uppsala, SwedenDepartment of Medicine, Cardiology Research Unit, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United StatesNEMA Research, Inc., Naples, FL, United StatesDepartment of Pharmacy Practice, Temple University School of Pharmacy, Philadelphia, PA, United StatesNEMA Research, Inc., Naples, FL, United StatesPaolo Procacci Foundation, Rome, ItalyA 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.https://www.frontiersin.org/articles/10.3389/fpain.2021.691720/fullcanceropioidopioid dependencyopioid use disorderpaincancer pain |
| spellingShingle | Joseph V. Pergolizzi Peter Magnusson Peter Magnusson Paul J. Christo Jo Ann LeQuang Frank Breve Kailyn Mitchell Giustino Varrassi Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency Frontiers in Pain Research cancer opioid opioid dependency opioid use disorder pain cancer pain |
| title | Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency |
| title_full | Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency |
| title_fullStr | Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency |
| title_full_unstemmed | Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency |
| title_short | Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency |
| title_sort | opioid therapy in cancer patients and survivors at risk of addiction misuse or complex dependency |
| topic | cancer opioid opioid dependency opioid use disorder pain cancer pain |
| url | https://www.frontiersin.org/articles/10.3389/fpain.2021.691720/full |
| work_keys_str_mv | AT josephvpergolizzi opioidtherapyincancerpatientsandsurvivorsatriskofaddictionmisuseorcomplexdependency AT petermagnusson opioidtherapyincancerpatientsandsurvivorsatriskofaddictionmisuseorcomplexdependency AT petermagnusson opioidtherapyincancerpatientsandsurvivorsatriskofaddictionmisuseorcomplexdependency AT pauljchristo opioidtherapyincancerpatientsandsurvivorsatriskofaddictionmisuseorcomplexdependency AT joannlequang opioidtherapyincancerpatientsandsurvivorsatriskofaddictionmisuseorcomplexdependency AT frankbreve opioidtherapyincancerpatientsandsurvivorsatriskofaddictionmisuseorcomplexdependency AT kailynmitchell opioidtherapyincancerpatientsandsurvivorsatriskofaddictionmisuseorcomplexdependency AT giustinovarrassi opioidtherapyincancerpatientsandsurvivorsatriskofaddictionmisuseorcomplexdependency |