Catch-22 for cancer patients who use opioids

Cancer patients have been abandoned because the US is tackling the use of opioids, experts warn.

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The highly addictive painkillers offer rare moments of relief from debilitating pain caused by most cancers and the treatments used to combat it, such as chemotherapy.

A new study, published today, warns that there are no clear guidelines to help cancer patients prevent them from becoming addicted, meaning that more and more survivors are struggling with a new disease: addiction.

However, another one study presented at an international cancer conference in Lisbon on Monday warned cancer patients struggling to get the necessary pain relief amid nationwide action against opioid prescriptions.

It is a Catch-22 situation that experts say is ignored and requires urgent attention.

Today, more than two-thirds of people diagnosed with cancer are expected to survive at least five years or more - less than half in the 1970s. However, there are still major obstacles when it comes to improving the quality of life, and pain is the biggest challenge (file image)

Today, more than two-thirds of people diagnosed with cancer are expected to survive at least five years or more – less than half in the 1970s. However, there are still major obstacles when it comes to improving the quality of life, and pain is the biggest challenge (file image)

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Professor Eric Winer, director of the Breast Cancer Program at Dana-Farber and the Harvard Cancer Center, and co-chair of the Lisbon conference, said: “We recognize that the abuse of opioids is a major problem, especially in the United States, but we must ensure that we do not interfere with pain management in cancer patients when tackling this problem. & # 39;

In recent decades, cancer research has led to enormous successes.

Today, more than two-thirds of people diagnosed with cancer are expected to survive at least five years or more – less than half in the 1970s.

However, there are still major obstacles when it comes to improving the quality of life, and pain is the biggest challenge.

More than half of cancer patients who undergo chemotherapy, radiation therapy or a similar severe treatment experience pain.

Opioids seemed to be the antidote: the incredibly powerful pills even mask extreme pain and often have a good feeling.

In addition, patients may be prescribed a few bottles of the stuff, meaning they will never be left in a tight spot again and suffer pain at night or during the weekend when the doctor's office is closed.

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But the addiction and overdose epidemic that has hit the US in recent years, killing hundreds of thousands of Americans, has exposed the danger of freely prescribing such powerful drugs, and panic has begun in the medical community.

Now that opioid suppliers and prescription doctors are confronted with federal lawsuits, clinics are trying to limit painkillers nationwide.

And rightly so, says James D Murphy, an oncologist at La Jolla University in California, who today published the new study published in the Journal of the National Cancer Institute.

& # 39; Use of opioids entails a risk of problems with prolonged use or abuse, & # 39; said Dr. Murphy. & # 39; From a healthcare provider's perspective, we need better approaches to identify cancer patients at risk for these opioid-related problems. & # 39;

There are guidelines to help cancer patients prevent opioid dependence, Murphy says, but they are vague.

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More importantly, he says, little is done to identify patients with the highest risk of addiction after treatment.

Dr. Murphy and colleagues analyzed a cohort of 107,000 patients and found that opioid addiction is more common in some cancers than in others. For example, 19.8 percent of patients with liver cancer developed dependence on painkillers after treatment, compared to 5.3 percent of patients with prostate cancer.

They also discovered that certain demographic data had a higher risk. Just like the general population, patients had a higher risk of opioid addiction if they were white, young, unemployed or on a low income and were a smoker.

For Lucas K. Vitzthum, an author of the study, this shows that hospitals can do a lot to prevent addiction by screening patients for these risk factors.

& # 39; Ultimately, clinical tools such as ours can help providers determine which patients can benefit from alternative pain management strategies or referral to pain specialists, & # 39; said Vitzthum.

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Other ideas presented by the 1500 experts at the Lisbon conference included improving access to cannabis for pain relief (although they emphasized that it should not be a wholesale substitute).

Regardless of the substance, it is information that is important, says Dr. Paul Little, medical director of Laguna Treatment Hospital, a detox center for drugs and alcohol in Orange County.

& # 39; The big problem is education, & # 39; Dr. told Little, who was not involved in the investigation, to DailyMail.com.

& # 39; Many patients tell me that their doctor has not informed them at all about the potential to develop dependence on these drugs.

& # 39; Time must be spent on a thorough evaluation of the patient's past, including a family or personal history of addiction. & # 39;

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