Temporal Trends and Predictors of Opioid Use Among Older Patients With Cancer.

Journal Article (Journal Article)


While opioids represent a cornerstone of cancer pain management, the timing and patterns of opioid use in the cancer population have not been well studied. This study sought to explore longitudinal trends in opioid use among Medicare beneficiaries with nonmetastatic cancer.

Materials and methods

Within a cohort of 16,072 Medicare beneficiaries ≥66 years old diagnosed with nonmetastatic cancer between 2007 and 2013, we determined the likelihood of receiving a short-term (0 to 6 mo postdiagnosis), intermediate-term (6 to 12 mo postdiagnosis), long-term (1 to 2 y postdiagnosis), and high-risk (morphine equivalent dose ≥90 mg/day) opioid prescription after cancer diagnosis. Multivariable logistic regression models were used to identify patient and cancer risk factors associated with these opioid use endpoints.


During the study period, 74.6% of patients received an opioid prescription, while only 2.66% of patients received a high-risk prescription. Factors associated with use varied somewhat between short-term, intermediate-term, and long-term use, though in general, patients at higher risk of receiving an opioid prescription after their cancer diagnosis were younger, had higher stage disease, lived in regions of higher poverty, and had a history of prior opioid use. Prescriptions for high-risk opioids were associated with individuals living in regions with lower poverty.


Temporal trends in opioid use in cancer patients depend on patient, demographic, and tumor characteristics. Overall, understanding these correlations may help physicians better identify patient-specific risks of opioid use and could help better inform future evidence-based, cancer-specific opioid prescription guidelines.

Full Text

Duke Authors

Cited Authors

  • Salans, M; Riviere, P; Vitzthum, LK; Nalawade, V; Murphy, JD

Published Date

  • February 2022

Published In

Volume / Issue

  • 45 / 2

Start / End Page

  • 74 - 80

PubMed ID

  • 35019879

Electronic International Standard Serial Number (EISSN)

  • 1537-453X

International Standard Serial Number (ISSN)

  • 0277-3732

Digital Object Identifier (DOI)

  • 10.1097/coc.0000000000000888


  • eng