MAY 14, 2024
Data indicate that recent efforts to combat the opioid epidemic by reducing narcotics administered to patients leads to higher levels of pain in Veterans Affairs patients with cancer.
“Our study reveals that while opioid safety measures are crucial, they may inadvertently hinder pain management in VA cancer patients, leading to increased reports of severe pain,” study author Sesh Mudumbai, MD, MS, an associate professor in the Department of Anesthesiology, Perioperative and Pain
Data indicate that recent efforts to combat the opioid epidemic by reducing narcotics administered to patients leads to higher levels of pain in Veterans Affairs patients with cancer.
“Our study reveals that while opioid safety measures are crucial, they may inadvertently hinder pain management in VA cancer patients, leading to increased reports of severe pain,” study author Sesh Mudumbai, MD, MS, an associate professor in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine, in California, told Pain Medicine News. “This underscores the need for a more nuanced approach to opioid prescribing that adequately addresses the unique needs of cancer care.”
The retrospective study included analysis of the medical records of 89,569 patients at Palo Alto VA Medical Center from 2015 to 2021 (JNCI Cancer Spectr 2024;8[2]:pkae01). The 9,073 cancer patients were nearly twice as likely to have an opioid prescription as noncancer patients (69.0% vs. 36.7%, respectively).
During the study period, the proportion of patients who received an opioid prescription decreased from 27.1% to 18.1% (P<0.01) among patients with cancer, and from 17.0% to 10.2% among noncancer patients (P<0.01).
Both groups of patients had similar reductions in morphine milligram equivalents (MME) per year between 2015 and 2019. However, the decline in MME from 2019 to 2021 was more rapid for cancer patients (1,462.5 to 946.4 MME; 35.3%) than noncancer patients (1,315.6 to 927.7 MME; 29.5%). The researchers found that the proportion of noncancer patients who experienced severe pain was nearly unchanged, while it increased among cancer patients, reaching a statistically significantly higher rate than that among noncancer patients in 2021 (31.9% vs. 27.4%, respectively).
“Future research should broaden its scope to multiple centers and delve into the causative factors behind opioid prescribing patterns for VA cancer patients,” Mudumbai concluded. “This will help in developing comprehensive pain management strategies that are both effective and safe.”
—Myles Starr
Mudumbai reported no relevant financial disclosures.
