Are patients undergoing surgery for early-stage cancer at risk of persistent opioid use?

New research indicates that many patients who undergo surgery with the intent to cure early‐stage cancer continue or start opioid prescriptions in the year following surgery. The findings are published in Cancer.

Pain management is essential during cancer care, but prescription opioid practices associated with cancer treatment may lead to unsafe long‐term opioid use and adverse outcomes such as opioid use disorder and opioid overdose.

To assess the situation, investigators examined rates of new persistent opioid use in the year following surgery for stage 0 to 3 cancers among 9,213 U.S. veterans who were opioid‐naive (not on prescribed opioids the year prior to their cancer diagnosis).

The team found that potentially dangerous co‐prescription of opioid and benzodiazepine (a central nervous system depressant that treats anxiety, insomnia, and seizures and should not be combined with opioids) medications occurred in 366 (4.0%) veterans during follow‐up. Persistent opioid use occurred in 981 (10.6%).

A higher intensity of exposure to opioid prescriptions during treatment was associated with these outcomes. People with a prior history of chronic pain, greater comorbidities, lower socioeconomic status, and who received adjuvant chemotherapy were at especially high risk of opioid use in the year after surgery.

“Minimizing opioid exposure associated with cancer treatment while providing effective pain control will decrease long‐term health risks among cancer survivors,” said lead author Marilyn M. Schapira, MD, MPH, of the University of Pennsylvania. “This is important as many patients are living longer after a cancer diagnosis and treatment.”