Safe Opioid Use, Storage, and Disposal Strategies in Cancer Pain Management

Abstract

Lung cancer is the most fatal malignancy in China. This study assessed genomic alterations of driver genes in a cohort of Chinese patients with non‐small cell lung cancer. This article reports the resulting analysis of germline mutations, EGFR variations, and ALK rearrangements, the most common and important driver genes in Chinese NSCLC population.

Abstract

Opioids are required by a majority of patients with advanced cancer. Oncologists and palliative care clinicians are faced with the challenge of safely prescribing opioids in the current environment of an opioid crisis. Many patients with cancer use opioids unsafely, store them in unsecure locations, and do not dispose of unused opioids, leading to increased availability of these opioids for others to misuse. More than 50% of people who misuse opioids obtain the drugs from a friend or relative with or without their consent. Patient and provider education has been shown to improve safe opioid use, promote secure storage, and also increase disposal of unused opioids safely in drug take‐back programs that are now widely available. This article highlights the importance of patient education and cautious opioid prescribing in patients with cancer.

Implications for Practice.

The current opioid crisis makes it challenging to effectively manage cancer pain. Providers play a prominent role in minimizing opioid misuse. Cautious prescribing with limits enforced on the quantity of opioids prescribed, close follow‐up, and consistent and frequent provision of opioid education are a must. Evidence points to the impact of patient education in promoting safety around opioid use. Most people who misuse prescription opioids obtain them from family or friends. Storing opioids in the open or not disposing of unused opioids increases the availability of these opioids for misuse by others. The importance of not sharing, always locking up, and disposing of unused and expired opioids must be highlighted as part of the opioid education that must be delivered every time that opioids are prescribed. Information about local drug take‐back programs may also help increase disposal of unused opioids.

Translated abstract

摘要

大多数晚期癌症患者都需要使用阿片类药物。当前阿片类药物出现环境危机，肿瘤学家和姑息治疗临床医生难以安全开具阿片类药物处方。许多癌症患者使用阿片类药物不安全，将其储存在不安全的地方，对于未使用的阿片类药物不及时丢弃，导致阿片类药物被他人滥用的可能性增加。50% 以上误用阿片类药物的人，均为从朋友或亲戚手中(同意或未经同意的情况下)取得这些药物。研究证明，患者与提供者的教育知识可以提高阿片类药物的安全使用、安全存储，并安全处理未使用的阿片类药物，回收到目前范围面广的药物回收计划中。本文强调了对癌症患者进行患者教育，谨慎开具阿片类药物处方的重要性。

实践意义:目前的阿片类药物危机增加了有效控制癌症疼痛的难度。提供者在减少阿片类药物误用问题上发挥着重要作用。必须谨慎开具处方，对所开具的阿片类药物数量加以限制，密切随访，持续不断地开展阿片类药物教育。有证据表明，患者教育对促进阿片类药物使用的安全性有积极影响。大多数滥用处方阿片类药物的人都是从家人或朋友那里获得的此类药物。将阿片类药物存储在暴露位置，或不处理未使用的阿片类药物，增加了阿片类药被他人误用的可能。必须在每次开具阿片类药物时对患者进行教育，强调不与他人分享、始终上锁存储并及时处理掉未使用或过期的阿片类药物。提供有关当地药品回收计划的信息，也可能有助于增加对未使用阿片类药物的处理。