Opioid Abuse and Dependence in Those Hospitalized Due to Head and Neck Cancer

In the United States, 2.1 million people develop substance abuse disorders that are associated with prescribed opioids. The objective of the present study was to identify the factors associated with opioid abuse and dependence (OAD) in those hospitalized for head and neck cancer (HNC). Although measures are being implementing to reduce opioid prescribing, the use of these drugs in individuals with HNC can be valuable. However, little is known about OAD among this cohort of individuals.

The present study was a retrospective analysis of the Nationwide Inpatient Sample for 2012 to 2014. All patients hospitalized because of any HNC were selected. The OAD prevalence was identified. The patient demographic, hospital, and geographic factors were considered independent variables and OAD was the outcome. Multivariable logistic regression model was used to identify the factors associated with OAD.

A total of 92,055 patients were hospitalized because of HNCs. OAD was prevalent in 0.8% of the patients. The OAD rates were greatest in patients with a malignant neoplasm of ill-defined sites within the lip, oral cavity, and pharynx (1.6%). Age 30 to 44 years (odds ratio [OR] 5.19, 95% confidence interval [CI] 2.23 to 12.06; P < .01) and age 45 to 64 years (OR 4.05, 95% CI 2.15 to 7.61; P < .01) were associated with greater odds for OAD compared with age older than 64 years. Black (OR 1.76, 95% CI 1.12 to 2.78; P = .01) and Hispanic (OR 2.20, 95% CI 1.27 to 3.79; P < .01) race/ethnicity were associated with greater odds for OAD compared with white race/ethnicity. Individuals covered by Medicaid (OR 2.08, 95% CI 1.26 to 3.43; P < .01), and those who were uninsured (OR 2.27, 95% CI 1.05 to 4.89; P = .04) were associated with greater odds for OAD compared with those covered by private insurance. An increase in the comorbid burden was associated with increased odds of OAD (OR 1.57, 95% CI 1.47 to 1.68; P < .001).

The present study identified specific anatomic sites where malignant neoplasm was associated with greater odds of OAD. Additionally, the study found that coverage by Medicaid, black and/or Hispanic race/ethnicity, lowest income households, and a greater comorbid burden were associated with greater odds of OAD.