Despite the common use of opioids in clinical settings, new and persistent opioid prescriptions have declined among patients both with and without cancer, according to new findings presented by Baum et al at the 2023 ASCO Annual Meeting (Abstract 1592). However, the declines in opioid use among patients with cancer were less drastic than those without cancer.
Study Details
In response to the opioid epidemic in the United States, interventions to prevent the overprescription and misuse of the drugs have been enacted at institutional, state, and federal levels. In the new study, the researchers focused on data from the Surveillance, Epidemiology, and End Results–Medicare program to examine the rates of new and persistent opioid prescribing among patients with and without cancer. The researchers identified 238,470 patients who had cancer, with a median age of 76.3 years, and assessed how changes in the prescribing landscape may have affected them.
New opioid use was found to be higher in patients with cancer (46.4%) compared with use in those without cancer (6.9%). From 2012 to 2017, the predicted probability of new opioid use was more stable in the cancer group—demonstrating relative declines of 2.4% for patients who had surgery and were prescribed opioids, 0.4% for patients who had surgery alone, and 8.8% for patients with metastatic cancer—compared with the noncancer group, which had an overall relative decline of 20%. The results showed that opioid prescribing declined over time at a slower rate in patients with cancer than in patients without cancer. The researchers noted that the results of the study revealed the important but tempered effects of the changing opioid climate in patients with cancer.
Conclusion
“Our findings show there has been a change in opioid prescribing across the board, including for patients with cancer, particularly in long-term cancer survivorship,” explained lead study author Laura Van Metre Baum, MD, MPH, Assistant Professor of Medicine (Medical Oncology) at the Yale School of Medicine. “At the same time, the results are reassuring that patients with cancer have maintained access to needed opioids following cancer surgery or with metastatic disease,” she added.
The researchers hope their findings may help improve the understanding of new and persistent opioid use, the impact of changing policies, and best practices for prescribing opioids for patients living with cancer.
“This work was only possible [because of] the strong collaborative spirit and support among Yale investigators, Mayo Clinic investigators, and the U.S. Food and Drug Administration [FDA],” concluded senior study author Henry Soo-Min Park, MD, MPH, Associate Professor of Therapeutic Radiology, Vice Chair for Clinical Research, and Chief of the Thoracic Radiotherapy Program in the Department of Therapeutic Radiology at the Yale School of Medicine.
Disclosure: The research in this study was supported by the FDA as part of a financial-assistance award from the U.S. Department of Health and Human Services. For full disclosures of the study authors, visit meetings.asco.org.
