Opioid-Related Hospitalizations Among Patients With Cancer in the United States
In a study reported in a research letter in JAMA Oncology, Chua et al found that opioid-related hospitalizations among American patients with cancer are rare, increasing at a very low rate, and consist mostly of hospitalization for nonheroin opioid poisoning.
The study analyzed trends and risk factors of opioid-related hospitalizations among patients with cancer between January 2006 and December 2014, using data from the U.S. National Inpatient Sample of the Healthcare Cost and Utilization Project.
Rates and Risk Factors
Among a total of 25,004,243 hospitalizations for patients with cancer over the study period, 14,095 (0.06%) were opioid-related hospitalizations. Analysis of the trend in overall number of opioid-related hospitalizations from 2006 to 2014 yielded an average annual increase of 78.9 admissions per year, from 1,170 to 1,715 (P = .01). In analysis adjusting for all-cause hospitalizations, the linear time trend of opioid-related hospitalizations indicated an average increase of 0.003% per year (P = .003).
Nonheroin opioid poisoning accounted for 88.0% of all opioid-related hospitalizations. Factors associated with hospitalizations included drug abuse (odds ratio [OR] = 7.92, 95% confidence interval [CI] = 6.95–9.02), depression (OR = 2.34, 95% CI = 2.13–2.58), psychotic disorder (OR = 4.13, 95% CI = 3.66–4.65), white race, younger age, and year of hospitalization. An association of alcohol abuse with opioid-related hospitalization did not achieve statistical significance (OR = 1.15, 95% CI = 0.99-1.35).
The investigators concluded, “Opioid-related hospitalizations among patients with cancer are rare, are increasing at a very low rate over time, and are largely associated with nonheroin opioid poisoning. The characteristics associated with opioid-related hospitalizations among patients with cancer are consistent with established risk factors for opioid abuse in the noncancer population… Additional research on opioid risk screening and management for patients with combined cancer and substance use disorders is needed.”
Isaac S. Chua, MD, of the Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, is the corresponding author for the JAMA Oncology article.
Disclosure: The study was supported by awards from the National Palliative Care Research Center and Gloria Spivak Fund. The study authors’ full disclosures can be found at jamanetwork.com.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
