Alcohol, Tobacco, and Substance Use and Association with Opioid Use Disorder in Patients with Non-malignant and Cancer P
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OPIOID USE IN AN OPIOID EPIDEMIC (S DALAL, SECTION EDITOR)
Alcohol, Tobacco, and Substance Use and Association with Opioid Use Disorder in Patients with Non-malignant and Cancer Pain: a Review Rony Dev 1
&
Ali Haider 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review The following review will highlight recent studies reporting associations between alcohol and tobacco use with non-medical opioid use in the post-operative period, as well as patients with chronic non-malignant and cancer pain. Recent Findings The use of alcohol, tobacco, and other illegal substances are associated with an increased risk of opioid use disorder in the post-operative setting and in patients with chronic non-malignant and cancer pain. Summary Opioid overdoses are at a national epidemic afflicting the general population. A comprehensive assessment of the risk for opioid use disorder is advocated prior to the prescription of opioids and includes obtaining a family and personal history of any substance use including alcohol and tobacco, as well as any psychiatric mood disorders. Strategies to manage pain in patients with high risk for opioid use disorders include decreased intervals between clinic visits, increase frequency of compliance monitoring with urine drug screens, and psychosocial support. Keywords Substance use disorder . Opioid use disorder . Alcohol . Tobacco . Non-medical opioid use
Introduction Substance use and substance use disorders (SUD) are a national epidemic afflicting the general population with deleterious medical, social, and economic consequences [1]. The Diagnostic and Statistical Manual of Mental Disorder 5 defines SUD as a constellation of behaviors involved in compulsive drug seeking including impaired control of substance use, impaired social interactions with others because of substance use, risky drug use (e.g., substance use in a hazardous settings), and pharmacological changes (e.g., experiencing withdrawal symptoms). Alcohol, tobacco, and other SUDs have been associated with decreased productivity, increased accidents, and financial hardship [2]. In addition, mood disorders
This article is part of the Topical Collection on Opioid Use in an Opioid Epidemic * Rony Dev [email protected] 1
Symptom Control & Palliative Medicine, University of Texas M D Anderson Cancer Center, 1515 Holcombe Blvd Unit 1212, Houston, TX 77021, USA
often accompany SUDs complicating treatment and requiring increased healthcare resources. From 1996 to 2018, the rates of accidental overdose of prescription opioids increased roughly fourfold [3]. In 2017, results from the 2017 National Survey on Drug Use and Health, an estimated 11.4 million Americans engaged in non-medial opioid and illegal drug use [4]. The overdose epidemic frequently encompasses not only non-medical prescription opioid overdoses but also opioids in combination with other illegal drugs, including cocaine or heroin [5, 6], and opioids unlawfully obtained by family or friends [7]. In 2018, 67,367 drug overdose d
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