Cancer patients are often prescribed pain relievers, such as during recovery from surgical procedures. However, for many the use of opioid pain medications during treatment can cause abuse or dependence after it. Now, when cancer patients are living longer than ever, the quality of the protection of life in later years after treatment is becoming increasingly important, including protection against the risk of opioid dependence.
"We assumed that this long-term problem for some of our patients with head and neck cancer, but did not know how serious it is," - says the study's first author Jessica McDermott, MD, a researcher at the University of Colorado Cancer Center.
To identify the abuse of opioids in patients with head and neck cancer, the researchers analyzed SEER / Medicare database, and found 976 patients who were treated between 2008 and 2011 from cancer of the oral cavity or oropharynx. 811 of these patients received prescriptions for opioid analgesics during treatment. Three months after the end of treatment 150 of these patients continued to prescribe opioids are active. Six months after treatment, 68 patients, or 7 percent of the total population continued to use opioid pain medication. The results were published in Otolaryngology-Head and Neck Surgery.
McDermott suggests that as younger patients in this study and others at greater risk of opioid abuse, the true percentage of opioid abuse is probably higher than expected current research. Additional risk factors for continued opioid use include prescription opioids to treat cancer, as well as history of smoking and / or alcohol use.
Interestingly, patients who, as a first opioid administered oxycodone is less likely to continue its use after 3 and 6 months after treatment than patients who are initially prescribed hydrocodone or other opiates, including fentanyl, hydromorphone hydrochloride, meperidine, morphine, nalbuphine or tramadol.
"We do not know why there is this way, but we think that perhaps patients are more aware of the possibility of dependence in the case of oxycodone, than if they were prescribed less well-known drug or a drug that they consider less important," - says McDermott .
The Group considers the current study as a way to understand the system of pain control and opioid dependence in patients with head and neck cancer with the aim to change the strategy of doctors to control the pain.