In response to the opioid epidemic in the United States, interventions to prevent over-prescribing and misuse of opioids were enacted at institutional, state, and federal levels. To assess how changes in the prescribing landscape affected patients, a research team from the Yale COPPER Center examined the rates of both new and persistent opioid prescribing in patients with cancer as well as in patients without cancer, utilizing data from SEER-Medicare.
Yale Cancer Center member Henry Soo-Min Park, MD, MPH, an associate professor, vice chair for clinical research, and chief of the thoracic radiotherapy program for the Department of Therapeutic Radiology at Yale School of Medicine, will present research highlights on June 5, 2023, at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois.
In this study, researchers identified 238,470 patients with cancer with a mean age 76.3 years. New opioid use was higher in patients with cancer (46.4%) than in those without (6.9%). From 2012 to 2017, the predicted probability of new opioid use was more stable in the cancer group, the data showing relative declines of 2.4% for patients that had surgery and prescribed opioids, 0.4% for patients with surgery alone, and 8.8% for patients with metastatic cancer, compared to the non-cancer group that had an overall relative decline of 20%. The results showed that opioid prescribing declined over time at a slower rate in patients with cancer than in patients without cancer. The researchers say the study shows important but tempered effects of the changing opioid climate on patients with cancer.
“Our findings show that there has been a change in opioid prescribing across the board, including for patients with cancer, particularly in long-term cancer survivorship,” says lead researcher and Yale Cancer Center member Laura Baum, MD, MPH, assistant professor of medicine (medical oncology) at Yale School of Medicine. “At the same time, the results are reassuring that patients with cancer have maintained access to needed opioids following cancer surgery or with metastatic disease.”
The ASCO presentation takes a closer look at the potential implications – and future directions for – improving the understanding of new and persistent opioid use, the impact of changing policies, and best practices for prescribing opioids for patients living with cancer.
“This work was only possible due to the strong collaborative spirit and support among Yale investigators, Mayo Clinic investigators, and the U.S. Food and Drug Administration (FDA),” says Park.
This research was supported by the FDA as part of a financial-assistance award from the U.S. Department of Health and Human Services.