Opioid use among patients with cancer does not appear to contribute to the steep increase in overdoses seen in the general public, according to a study by researchers at the Duke Cancer Institute (DCI).
The study, presented September 28, 2018 at the American Society of Clinical Oncology Quality Care Symposium in Phoenix, AZ, found that death from opioids is 10 times less likely to occur in patients with cancer than in the general population.
During a 10-year period from 2006 to 2016, the researchers found that opioid-related deaths in the general population increased from 5.33 to 8.97 per 100,000 people. For patients with cancer, the rate rose from 0.52 to 0.66 per 100,000. In total, 895 patients with cancer died as a result of opioids during that period, compared with 193,500 in the general population.
“Virtually no cancer patient I talk to wants take to these medications to get through treatment,” says Fumiko Chino, MD, a radiation oncologist at DCI who presented the findings.
“I have to cajole them to take opioids for pain management,” she says. “But this study should give doctors some reassurance that the rate of opioid-related deaths among cancer patients is very low, and their patients are not going to be a statistic in the opioid epidemic.”
Chino and colleagues used de-identified death certificate data from the National Center for Health Statistics, which cites one underlying cause of death and up to 20 contributing causes, as well as demographic data.
All deaths due to opioids were included; if present, cancer was noted as a contributing cause. The incidence of opioid-related death was calculated in both the United States and the estimated cancer survivor population.
“We know the United States is in a bad place with the opioid epidemic, and the main concern with oncologists is whether we need to be more restrictive in prescribing these medications to cancer patients, given the rapid rise in deaths in the general population,” Chino explains. “But part of our ability to successfully treat cancer includes the use of these medications,” she says. “This research shows that for this vulnerable population, the risk of overdose death is quite low.”