Comparison of Oncology Patients’ and Their Family Caregivers’ Attitudes and Concerns Toward Pain and Pain Management

Valeberg, Berit Taraldsen; Miaskowski, Christine; Paul, Steven M.; Rustøen, Tone

doi:10.1097/ncc.0000000000000319

Cited by 26 publications

(11 citation statements)

References 40 publications

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“…Although there are no randomized trials comparing marijuana and prescription opioids for cancer‐related pain, patients are increasingly reporting the use of cannabis as a substitute for prescription opioids . Oncology patients may have apprehensions about opioids, including a fear of dependence and potential side effects . Indeed, the most commonly reported motivation for opioid misuse is relief from physical pain, yet these fears introduce potential barriers to effective cancer pain management .…”

Section: Discussionmentioning

confidence: 99%

“…[39][40][41] Oncology patients may have apprehensions about opioids, including a fear of dependence and potential side effects. 42 Indeed, the most commonly reported motivation for opioid misuse is relief from physical pain, 31 yet these fears introduce potential barriers to effective cancer pain management. 42 Medical marijuana legalization has been associated with a 23% reduction in hospitalizations related to opioid dependence or abuse, and this suggests that if patients are in fact substituting marijuana for opioids, this substitution may reduce the risks of opioid-related health problems.…”

Section: Discussionmentioning

confidence: 99%

“…42 Indeed, the most commonly reported motivation for opioid misuse is relief from physical pain, 31 yet these fears introduce potential barriers to effective cancer pain management. 42 Medical marijuana legalization has been associated with a 23% reduction in hospitalizations related to opioid dependence or abuse, and this suggests that if patients are in fact substituting marijuana for opioids, this substitution may reduce the risks of opioid-related health problems. 22 However, most large-scale randomized trials of marijuana use for pain are limited to noncancer pain, 17 and there may be potential adverse effects of marijuana use that should be considered.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The role of cancer in marijuana and prescription opioid use in the United States: A population‐based analysis from 2005 to 2014

Tringale

Huynh‐Le

Salans

et al. 2019

Cancer

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Background For patients with cancer, marijuana may be an alternative to prescription opioid analgesics. This study analyzed self‐reported marijuana and prescription opioid use among people with cancer over a 10‐year time period. Methods Population‐based data sets from the US National Health and Nutrition Examination Survey between 2005 and 2014 were compiled for respondents aged 20 to 60 years. Respondents with cancer and respondents without cancer were propensity score–matched (1:2) by demographics to compare substance use. Outcomes included current marijuana and prescription opioid use (ie, within the past 30 days). Pearson chi‐square tests and logistic regressions were performed; a 2‐tailed P value < .05 was significant. Results There were 19,604 respondents, and 826 people with cancer were matched to 1652 controls. Among the respondents with cancer, 40.3% used marijuana within the past year, and 8.7% used it currently. Respondents with cancer were significantly more likely to use prescription opioids (odds ratio [OR], 2.43; 95% CI, 1.68‐3.57; P < .001). Cancer was not associated with current marijuana use in a multivariable conditional logistic regression but was associated with current opioid use (OR, 1.82; 95% CI, 1.17‐2.82; P = .008). Among all survey respondents, the odds of marijuana use significantly increased over time (OR, 1.05; 95% CI, 1.01‐1.10; P = .012), whereas the odds of opioid use did not significantly change. There were no significant differences in the longitudinal odds of marijuana or opioid use over time between respondents with a cancer diagnosis and those without one. Conclusions This population‐based analysis revealed a considerable proportion of respondents with cancer self‐reporting marijuana use (40.3%) and a significantly higher prevalence of opioid use among respondents with cancer. In the midst of an opioid epidemic, an evolving political landscape, and new developments in oncology, quantifying the prevalence of opioid and marijuana use in the US population, especially among patients with cancer, is particularly relevant. Although opioid use did not significantly change from 2005 to 2014 among all respondents, marijuana use did increase, likely reflecting increased availability and legislative changes. A cancer diagnosis did not significantly affect longitudinal opioid or marijuana use.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The role of cancer in marijuana and prescription opioid use in the United States: A population‐based analysis from 2005 to 2014

Tringale

Huynh‐Le

Salans

et al. 2019

Cancer

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“…A large study of 4707 cancer survivors revealed that two‐thirds reported at least 1 barrier to cancer pain management, with the most vulnerable groups—those who were nonwhite, less educated, older, or having more comorbidities—being most adversely affected . Numerous studies have examined specific barriers expressed by patients and family/caregivers regarding pain and pain management, with fears of addiction consistently being cited as a substantial concern . Physician barriers to cancer pain management include inadequate assessments and a reluctance to administer and prescribe opioids .…”

Section: Introductionmentioning

confidence: 99%

Cancer pain management and the opioid crisis in America: How to preserve hard‐earned gains in improving the quality of cancer pain management

Paice

2018

Cancer

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Cancer pain remains a feared consequence of the disease and its treatment. Although prevalent, cancer pain can usually be managed through the skillful application of pharmacologic and nonpharmacologic interventions. Unfortunately, access to these therapies has been hampered by interventions designed to contain another serious public health problem: the opioid misuse epidemic. This epidemic and the unintended consequences of efforts to control this outbreak are leading to significant barriers to the provision of cancer pain relief. Oncologists and other professionals treating those with cancer pain will require new knowledge and tools to provide safe and effective pain control while preventing additional cases of substance use disorders (SUDs), helping patients in recovery to maintain sobriety, and guiding those not yet in recovery to seek treatment. How do these 2 serious epidemics intersect and affect oncology practice? First, oncology professionals will need to adopt practices to prevent SUDs by assessing risk and providing safe pain care. Second, oncology practices are likely to see an increased number of patients with a current or past SUD, including opioid misuse. Few guidelines exist for the direct management of pain when opioids may be indicated in these individuals. Third, modified prescribing practices along with the education of patients and families are warranted to prevent the exposure of these medications to unintended persons. Finally, advocacy on behalf of those with cancer pain is imperative to avoid losing access to essential therapies, including opioids, for those who might benefit. Cancer 2018;124:2491-7. © 2018 American Cancer Society.

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“…However, three cases of eye distention were found with duloxetine treatment in our study. The observed mean difference in FACT-Tax pain score between the duloxetine and any other anti-neurotoxicity groups in paclitaxel chemotherapy regimens was larger than that reported by Goldstein (23). Duloxetine-related clinically meaningful improvement in other PIPN symptoms, such as weakness, joint pain, or muscle cramps, may be directly comparable with painful chemotherapyinduced peripheral neuropathy.…”

Section: Discussionmentioning

confidence: 54%

Efficacy and safety of duloxetine in Chinese breast cancer patients with paclitaxel-induced peripheral neuropathy

Wang

et al. 2017

Chinese Journal of Cancer Research

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Duloxetine is a promising and safe option with tolerable toxicity at a dose of 60 mg/d for Chinese breast cancer patients with PIPN. Non-neuropathy adverse events were mild and similar in both groups. The major toxicities of duloxetine included nausea, constipation, somnolence, dizziness and distention of the eyes. Further examination of the benefits of duloxetine in the prevention of PIPN is required.

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Comparison of Oncology Patients’ and Their Family Caregivers’ Attitudes and Concerns Toward Pain and Pain Management

Abstract: Patients and FCs need education about perceived barriers to effective pain management. They should be coached together to maintain or increase the congruence between them.

Cited by 26 publications

References 40 publications

The role of cancer in marijuana and prescription opioid use in the United States: A population‐based analysis from 2005 to 2014

The role of cancer in marijuana and prescription opioid use in the United States: A population‐based analysis from 2005 to 2014

Cancer pain management and the opioid crisis in America: How to preserve hard‐earned gains in improving the quality of cancer pain management

Efficacy and safety of duloxetine in Chinese breast cancer patients with paclitaxel-induced peripheral neuropathy

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