Psychosocial Factors and Opioid Use in an Adolescent and Young Adult Oncology Population

Author Type(s)

Faculty

Document Type

Abstract

Publication Date

2022

DOI

10.1002/pon.5872

Journal Title

Psycho-Oncology

Department

Pathology, Microbiology and Immunology

Second Department

Pediatrics

Abstract

Background/Purpose: Adolescents and Young adults (AYAs) oncology patients are at an elevated risk for misusing prescription opioid analgesics when compared to AYAs without cancer. We evaluated if mental illness predicted total opioid doses prescribed throughout cumulative hospital stay, hypothesizing that those with more severe psychological distress were prescribed more opioids. We also hypothesized that those who are employed and/or in school were prescribed fewer opioids compared to those unemployed and/ or not in school. Methods: A retrospective chart review of 33 AYA patient records (mean age 17.6 years at diagnosis) was performed from March 2018 to October 2020. Regression analysis was conducted to predict the total number of opioid medications prescribed based on a mental illness severity score using four different diagnostic categories of Adjustment Disorders, Depressive Disorders, Anxiety Disorders, and PTSD. Independent t-tests and ANOVA were used to compare the difference in total opioid doses prescribed based on social demographics. Results: Suffering more severe mental illness, as defined by the quantity of mental illness diagnoses, did not predict more opioid dose prescriptions during hospital stay (F(1, 26) = 0.274, p = 0.605). There was no difference in our sample between opioid doses received by those AYA patients who were employed or in school when compared to those who were unemployed or not in school (t(3.34) = 1.18, p = 0.315). There was no difference between number of opioid doses prescribed based on race, ethnicity, or sexual orientation, however female patients were prescribed marginally more opioid doses than males (t(13.39) = 2.01, p = 0.065). Conclusions and Implications: While this analysis does not suggest mental illness as a predictor for quantity of opioid prescriptions in an oncology setting, this information suggests that multiple factors outside of a mental health diagnosis may influence opioid prescriptions in the AYA population. Therefore, further highlighting the complexity of the interaction between psychologic distress and cancer pain management.

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