Chronic opioid use after laryngeal cancer treatment. Issue 4 (28th December 2020)

• Record Type: Journal Article
• Authors: Starr, Nicole; Oyler, Douglas R.; Schadler, Aric; Aouad, Rony K.
• Is Part Of: Head & neck. Volume 43:Issue 4(2021)
• Page Start: 1242
• Page End: 1251
• Publication Date: 2020-12-28
• Subjects: chronic use -- head and neck cancer -- laryngeal carcinoma -- larynx cancer -- opioid; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26591
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Survivors of head and neck cancer may be at increased risk for chronic opioid use and questions remain about risk factors. Methods: Retrospective study of patients with laryngeal cancer prescribed opioids utilizing the Truven Health Marketscan database. Patients had laryngeal cancer, underwent treatment, filled an opioid prescription, and were enrolled in this private insurance plan 1 year prior to and after treatment. Results: In this study, 7484 patients were included; 17.2% developed chronic opioid use, defined as consecutive opioid fills at least 90 days after treatment cessation. Early opioid use (OR = 3.607, 95% CI [3.125–4.163]), tobacco use (OR = 1.28, 95% CI [1.117–1.467]), median morphine milligram equivalent (MME; OR = 1.001, 95% CI [1.000–1.0001]), and radiation alone (OR = 1.435, 95% CI [1.199–1.717]) were predictive of chronic opioid use. Conclusions: Nearly one in five patients prescribed opioids during treatment developed chronic use. Providers should discuss the risk of chronic opioid use, set expectations for opioid weaning, and consider adjunct pain regimens to develop effective pain management strategies.