pain management

Opioid Prescriptions Decline for Patients with Non-Cancer, Cancer Pain

08/31/2022

The United States saw a decline in the number of privately insured adults who were prescribed opioid medication for cancer pain and chronic non-cancer pain (CNCP) between 2012 and 2019, according to a new study.1

The researchers used data from the IBM MarketScan Research Database to examine health insurance claim trends for individuals with a cancer diagnosis or a CNCP diagnosis. Patients with CNCP were defined as individuals diagnosed with any of the following: arthritis, headache, low back pain, and/or neuropathic pain.

The researchers found that the proportion of people that received an opioid prescription decreased among individuals with CNCP (49.7% to 30.5%, P < .01) and cancer-related pain (86.0% to 78.7%, P < .01). Non-pharmacologic therapy rose among individuals with CNCP (62.4% to 66.1%, P < .01). Furthermore, non-opioid medication receipt remained steady among individuals with CNCP (66.7% to 66.4%, P < .01) and increased for people with cancer (74.4% to 78.8%, P < .01).

Additionally, the study showed a decrease in high dosages of opioids and the number of days’ supply. The data showed a decrease in the receipt of at least 1 prescription with more than 90 MME/day (CCNCP 13.9% in 2012 to 4.9% in 2019 P < .01; cancer 26.2% to 7.6% P < .01) and less than 7 days of supply (CNCP 56.3% to 30.7%, p < .01; Cancer 47.5% to 22.7%, p < .01). Overall, the researchers concluded that there was a decline in opioid prescribing, the most significant decline in patients with CNCP.

“While clinical guidelines continue to endorse prescription opioid treatment for cancer-related pain, declines in receipt of any opioid prescription were observed for people with cancer diagnoses, though these declines were smaller in magnitude than those observed among people with CNCP diagnoses,” the researchers wrote. “Future research is needed to understand the clinical implications of this decline, as well as observed decreases in MME/day and days’ supply of opioid prescriptions, among cancer patients.”

The Centers for Disease Control and Prevention (CDC) is in the process of updating their 2016 recommendations2 for opioid prescribing, including guidelines for opioid prescription outside of cancer treatment, palliative care, and end-of-life care, while recommending non-opioid treatments as the first line of therapy for CNCP.

 

—Jessica Ganga

 

References:

  1. Bandara S, Bicket MC, McGinty EE. Trends in opioid and non-opioid treatment for chronic non-cancer pain and cancer pain among privately insured adults in the United States, 2012-2019. PLOS One. Published online August 10, 2022. doi:10.1371/journal.pone.0272142.
  2. Dowell D, Haegerich TM, Chou R. CDC Guideline for prescribing opioids for chronic pain – United States, 2016. MMWR mob Moral Wkly Rep. 2016;61(1):1-49. doi:10.15585/mmwr.rr6501e1external icon.