Aberrant opioid use behaviour in advanced cancer

Area of Science:

• Palliative Care
• Oncology
• Pain Management
• Psychiatry

Background:

• Opioid use in advanced cancer patients is common.
• Assessing aberrant opioid-related behaviors is critical for safe and effective pain management.
• Italy has unique cultural perspectives on opioid use.

Purpose of the Study:

• To evaluate aberrant behaviors in advanced cancer patients receiving opioids in Italy.
• To identify actual opioid misuse in clinical practice.
• To correlate risk assessment tools with observed behaviors.

Main Methods:

• Prospective observational study in two Italian palliative care units.
• Utilized Edmonton Symptom Assessment Scale, Memorial Delirium Assessment Scale, Brief Pain Inventory (BPI), Hospital Anxiety Depression Scale.
• Employed Screener and Opioid Assessment for Patients With Pain (SOAAP), Opioid Risk Tool (ORT), and CAGE-AID for aberrant opioid use risk assessment.

Main Results:

• 113 advanced cancer patients were assessed.
• 35% of patients screened positive on the SOAPP.
• SOAPP scores correlated with CAGE-AID and ORT, and were associated with lower Karnofsky level, higher pain intensity, and poorer well-being.

Conclusions:

• A significant percentage of patients exhibited a high risk for aberrant opioid behaviors.
• No patients displayed clinically aberrant behaviors within the 1-month follow-up period.
• Ongoing monitoring is essential for patients identified as high-risk for aberrant behaviors.