Disparities and burden of illness among hospitalized cancer patients with opioid dependence

Opoid dependency (OD) is associated with adverse clinical outcomes in hospitalized patients; nevertheless, the understanding of OD and its impact on cancer patients remains restricted. Alongside addressing the symptoms related to disease, hospitalized patients with OD also grapple with mental illness (MI) challenges and the risk of infectious consequences (ICs), which remain unrecognized in cancer patients. We utilized national inpatient database to examine patient and clinical characteristics among renal cell carcinomas (RCC), prostate cancers (PC) and cancers of the lip, oral cavity, and pharynx (CLOP). We used generalized linear models to evaluate the association of OD and outcome of burden of illness (BOI), specifically length of stay (LOS). We also evaluated the association between OD and emergency department (ED) referral/admission status, ICs (specifically septicemias), weight loss, fluid and electrolyte disorders (FED), status of MI screening, and anxiety and depressive disorders. Of the 88,105 RCC there were 610 OD patients; PC (209,410) with 1115 OD; CLOP (54,265) with 495 OD. PC patients with OD were associated with longer LOS (Coefficient, 1.59; 95%CI, 1.14-2.21), higher ED status (aOR, 2.60; 1.47-4.59), higher FED (aOR, 2.25;1.59-3.19), higher septicemia (aOR, 1.61;1.09-2.39), less MI screening (aOR: 0.59, 95%CI, 0.40-0.89), higher anxiety disorders (aOR,2.31;1.53-3.48), and higher depressive disorders (aOR, 2.22; 1.48-3.33). Similarly, RCC OD patients were associated with ED status (1.66; 1.01-2.73), FED (2.40;1.50-3.83) and septicemias (2.61;1.27-2.39). These findings were comparable in the CLOP cohorts. Among all cancer cohorts, compared to Whites, Hispanics were associated with more septicemias, and Blacks, when compared to Whites, had a longer LOS. The findings are particularly significant in light of the ongoing opioid epidemic and its effects on cancer patients. In exceptional clinical situations, including a high risk of mental disorder, exact criteria must be created for controlling cancer pain that allow safe opioid delivery, taking into account biological and psychosocial OD.