Opioid Resource Center
Opioid Resource Center
March 27, 2018
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Patients with head and neck cancer more likely to be prescribed opioids

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Patients with head and neck cancers appeared significantly more likely to receive opioid prescriptions than those who had lung cancer or colon cancer, according to a published research letter.

“Head and neck cancer pain represents a significant physical, psychological and financial burden for patients,” Rosh K.V. Sethi, MD, MPH, of the department of otolaryngology at Harvard Medical School, and colleagues wrote in JAMA Otolaryngology-Head & Neck Surgery. “Opioids remain a mainstay of treatment for these patients, and head and neck oncologists must balance the goal of optimal pain control with the risks of abuse. Current literature has not thoroughly characterized opioid prescription patterns among patients with head and neck cancer.”

The researchers conducted a cross-sectional analysis of the Prescription Medicine Files — part of the Medical Expenditures Survey conducted each year by the Agency for Healthcare Research and Quality — for the years 2011, 2013 and 2015.

Sethi and colleagues searched the database to assess the proportion of opioid prescriptions, mean payment per opioid prescription, duration of prescription and quantity of opioid prescriptions for patients with head and neck cancer, lung cancer or colon cancer.

The researchers identified 739 prescriptions in the analysis (n = 168 for head and neck cancer; n = 571 for lung or colon cancer).

Patients who had head and neck cancers had a significantly higher likelihood of being prescribed opioids than those who had lung or colon cancers (OR = 1.68; 95% CI, 1.13-2.49). Among patients prescribed oxycodone, those with head and neck cancer received a greater number of tablets than those who had lung cancer or colon cancer (mean, 87.1 vs. 71), although the researchers noted that “the standardized mean difference was highly variable” (Cohen d = 0.25; 85% CI, –10.9 to 11.36).

Researchers reported no difference between groups with regard to duration of drug supply or mean payment per prescription for opioids.

Sethi and colleagues acknowledged study limitations, including a lack of information about prior oncologic treatment, tumor stage and location, as well as possible comorbid chronic pain conditions.

“It is imperative that head and neck cancer physicians are mindful of opioid prescription trends for patients with head and neck cancer, especially in the context of the current opioid epidemic,” they wrote. “There is an urgent need for further quantification and understanding of postprocedural and chronic opioid use in this patient population.” – by Andy Polhamus

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Disclosures: The authors report no relevant financial disclosures.