William Dale, MD, PhD
It wasn't too many years ago that the primary concerns related to pain management for patients with cancer revolved around whether they were getting adequate relief. Now, with the United States in the throes of an opioid epidemic, the use of these powerful and addictive pain relievers for patients with cancer is coming under unprecedented scrutiny.
“Oncologists are accustomed to giving opioids, but we must also be comfortable taking them away and sometimes giving them in limited doses or not at all,” wrote Loren, an associate professor of medicine in the Division of Hematology/Oncology at the Hospital of the University of Pennsylvania in Philadelphia. “We need to be aware of risk factors for substance use disorders and tools for preventing and addressing them… Although many cancer survivors live with chronic health issues caused by their treatment, opioid addiction should not be one of them.”
Dimensions of the Epidemic
The emphasis on opioid prescribing practices in cancer care comes amid a grim litany of statistics about the nation’s drug abuse problems. Prescription opioids have been identified as significant contributors to the overdose epidemic. The Centers for Disease Control and Prevention (CDC) reports that more than 35% of all US opioid overdose deaths in 2017 involved a prescription.2
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