Isaac Chua MDInstructor of Medicine at Harvard Medical SchoolBoston, Massachusetts

Opioid-Related Hospitalizations Among Cancer Patients are Rare Interview with:

Isaac Chua MDInstructor of Medicine at Harvard Medical SchoolBoston, Massachusetts

Dr. Chua

Isaac Chua MD
Instructor of Medicine at Harvard Medical School
Boston, Massachusetts What is the background for this study?  

Response: Opioids are routinely prescribed for cancer-related pain, but little is known about the prevalence of opioid-related hospitalizations for patients with cancer. Although opioid addiction among patients with cancer is estimated to be as high as 7.7%, our understanding of opioid misuse is based on small, preliminary studies.

In light of the wider opioid epidemic, oncologists and palliative care clinicians frequently balance providing patients with legitimate access to opioids while protecting them and the general public from the risks of prescribing these medications. What are the main findings?

Response: From 2006 to 2014, there were 14,095 opioid-related hospitalizations among 25,004,243 hospitalizations overall for patients with cancer. We observed an average increase of 78.9 admissions per year (from 1,170 to 1,715, p=0.01). After adjusting for all-cause hospitalizations, the linear time trend of opioid-related hospitalizations for patients with cancer increased on average by 0.003% per year (p=0.003). Non-heroin opioid poisoning made up 88% of all opioid-related hospitalizations. Factors significantly associated with opioid-related hospitalizations for patients with cancer included drug abuse, depression, psychotic disorder, white race, younger age, and year of hospitalization. Alcohol abuse was associated with opioid-related hospitalizations, but the association was not significant. What should readers take away from your report?

Response: Opioid-related hospitalizations among patients with cancer are rare, are increasing at a very low rate over time, and are largely associated with non-heroin opioid poisoning. The characteristics associated with opioid-related hospitalizations among patients with cancer are consistent with established risk factors for opioid abuse in the non-cancer population. What recommendations do you have for future research as a result of this work?

Response: Additional research on opioid risk screening and management for patients with combined cancer and substance use disorders is needed. Is there anything else you would like to add?

Response: Prior to prescribing opioids for cancer-related pain, routinely screening patients using standardized tools based on risk factors for opioid abuse (eg, Opioid Risk Tool) may identify patients with the greatest risk of an opioid-related hospitalization. 

We do not have any disclosures.


Chua IS, Leiter RE, Brizzi KT, et al. US National Trends in Opioid-Related Hospitalizations Among Patients With Cancer. JAMA Oncol. Published online March 28, 2019. doi:10.1001/jamaoncol.2019.0042

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Mar 28, 2019 @ 5:28 pm 

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