2019
DOI: 10.1634/theoncologist.2019-0540
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Best Practices in the Management of Nonmedical Opioid Use in Patients with Cancer-Related Pain

Abstract: Introduction Nonmedical opioid use (NMOU) in patients with cancer is a term covering a spectrum of nonprescribed opioid use. The extent to which an individual uses opioids in a nonprescribed manner will influence propensity for adverse effects such as neurotoxicity, substance use disorder, overdose, and death. Objectives The objectives of this study were to (A) evaluate current literature regarding management of NMOU in patients with cancer‐related pain; (B) provide best practice recommendations based on evide… Show more

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Cited by 19 publications
(26 citation statements)
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“…This can increase the discomfort of children, affect their treatment processes, and lead to poor quality of life (Duran et al, 2020;Genik et al, 2020). To control cancer-related symptoms, pharmacotherapy has been widely used as a traditional treatment (Ulker & Del, 2020).…”
Section: Introductionmentioning
confidence: 99%
“…This can increase the discomfort of children, affect their treatment processes, and lead to poor quality of life (Duran et al, 2020;Genik et al, 2020). To control cancer-related symptoms, pharmacotherapy has been widely used as a traditional treatment (Ulker & Del, 2020).…”
Section: Introductionmentioning
confidence: 99%
“…Several studies mention the utility of pill counting as a component of opioid management; however, few include specific citations for these statements. Of the 24 full-text manuscripts assessed with potential eligibility and not included in the final analysis, only nine specifically reference the utility of pill counting [15][16][17][18][19][20][21][22][23]. Colasanti et al cited an article by Chou and colleagues, in which the authors state, "Because patient self-report may be unreliable for determining amount of opioid use, functionality, or aberrant drug-related behaviors, pill counts…can be useful supplements" (p. 123) [15,24].…”
Section: Discussionmentioning
confidence: 99%
“…A harm reduction approach to the care of persons with SUDs includes a focus on reducing the negative impacts of the harmful behavior without a focus on abstinence 30 . Using a harm reduction approach in the setting of a terminal illness, health care clinicians provide ongoing medical care and counseling on how to reduce negative outcomes of the illness or SUD 31,32 . Han 33 recently proposed a model of using a geriatric medicine approach in combination with harm reduction to better care for aging patients with complex comorbid medical conditions occurring simultaneously with SUDs.…”
Section: Special Considerations In the Setting Of Terminal Illnessmentioning
confidence: 99%
“…30 Using a harm reduction approach in the setting of a terminal illness, health care clinicians provide ongoing medical care and counseling on how to reduce negative outcomes of the illness or SUD. 31,32 Han 33 recently proposed a model of using a geriatric medicine approach in combination with harm reduction to better care for aging patients with complex comorbid medical conditions occurring simultaneously with SUDs. Oncology and palliative care clinicians may choose to pursue a harm reduction approach when caring for patients with painful terminal illness and active SUDs using a similar approach of focusing on individual counseling, supporting patient-specific goals, and risk reduction without a primary focus on fixing or curing the underlying problem, to help a person feel as well as they can for as long as they are alive, within the context of their illness.…”
Section: Special Considerations In the Setting Of Terminal Illnessmentioning
confidence: 99%