The following is a summary of “I Refused to Get Addicted to Opioids: Exploring Attitudes About Opioid Use Disorder in Patients With Advanced Cancer Pain and Their Support People,” published in the June 2023 issue of Pain by Bulls et al.

Opioids are commonly prescribed to patients with advanced cancer, but patient attitudes regarding opioid hazards (e.g., opioid use disorder or OUD) are understudied. The researchers used in-depth qualitative interviews to comprehend the perceptions of opioid prescribing and OUD among patients with advanced solid-tumor malignancies and their caregivers. They conducted a qualitative study using a rigorous inductive, qualitative descriptive methodology to investigate the attitudes of advanced cancer patients (n = 20) and support providers (n = 11) toward OUD. 

Cancer patients hold two seemingly contradictory perspectives: prescription opioids are addictive, but OUD cannot affect my loved ones or me. Participants described general concerns regarding the addictive nature of prescription opioids (“My biggest concern…would just be the risk of becoming addicted to the medication or even, like, overdosing on it”) while distinguishing cancer pain management from OUD when evaluating prescription opioid risks and benefits (“They need to make sure they get the right ones when they’re taking it away from you.”). In conclusion, participants identified personal characteristics and behaviors they perceived as protective against developing OUD (commonly, control, resolve, and responsibility). 

This rigorous qualitative study demonstrates that patients with advanced cancer and their caretakers are concerned about the addictive potential of prescription opioids while distancing themselves from perceptions of OUD risks associated with using opioids for cancer pain management. Given the high rates of opioid exposure during advanced cancer treatment, it is essential to investigate avenues for promoting a balanced understanding of prescription opioid use and OUD risks among this population. Even though prescription analgesics pose a risk of OUD, there are data to guide patients with advanced cancer. The findings suggest innovative strategies are required to promote effective pain management and reduce opioid risks in this complex population.

Source: sciencedirect.com/science/article/abs/pii/S1526590023000238