Rogers Andrew H, Pielech Melissa, Ketterl Tyler G, Palermo Tonya M
Division of Behavioral Medicine, Department of Medicine, University at Buffalo, State University of New York, Buffalo, New York, USA.
Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Psychooncology. 2025 Jan;34(1):e70082. doi: 10.1002/pon.70082.
Adolescents and young adults (AYA) with cancer experience long-term consequences into survivorship that impact quality of life, including mental health symptoms, substance use, and persistent pain. Given the elevated rates of pain, AYA cancer survivors are at increased risk for opioid pain medication (OPM) exposure, increasing risk for opioid-related negative consequences, particularly for those with mental health symptoms. Minimal research has documented that a considerable proportion of AYAs with cancer receive OPM that continues into survivorship, yet the lack of consensus on the definition of problematic opioid use coupled with the high clinical need for OPM makes it particularly challenging to understand the impact of OPM use in this population.
Therefore, the current study examined differences in opioid pain medication use, use behaviors, and motives between AYA cancer survivors and non-cancer controls.
Using the National Survey on Drug Use and Health, we tested the impact of OPM use behaviors and motives on depressive symptoms and mental healthcare utilization variables.
Results show that, compared to non-cancer controls, AYA cancer survivors evince higher rates of opioid use, behaviors, and pain relief motives. Within the cancer survivor group only, there were differential patterns of associations between OPM behaviors, motives, depressive symptoms, and mental healthcare utilization, with using opioid pain medication for emotion coping/to get high showed the largest effect sizes with outcome variables.
The results highlight the importance of moving beyond use itself and examining how and why AYAs with cancer are using opioids to understand potential negative consequences.
患有癌症的青少年和青年(AYA)在 survivorship 阶段会经历长期后果,这些后果会影响生活质量,包括心理健康症状、物质使用和持续性疼痛。鉴于疼痛发生率较高,AYA 癌症幸存者接触阿片类止痛药物(OPM)的风险增加,与阿片类药物相关的负面后果风险也随之增加,尤其是对于那些有心理健康症状的人。极少有研究记录表明,相当一部分患有癌症的 AYAs 会持续使用 OPM 直至 survivorship 阶段,但对于问题性阿片类药物使用的定义缺乏共识,再加上对 OPM 的临床需求较高,这使得了解 OPM 在该人群中的使用影响变得特别具有挑战性。
因此,本研究调查了 AYAs 癌症幸存者与非癌症对照者在阿片类止痛药物使用、使用行为和动机方面的差异。
利用全国药物使用和健康调查,我们测试了 OPM 使用行为和动机对抑郁症状和心理保健利用变量的影响。
结果显示,与非癌症对照者相比,AYA 癌症幸存者表现出更高的阿片类药物使用率、行为和止痛动机。仅在癌症幸存者组中,OPM 行为、动机、抑郁症状和心理保健利用之间存在不同的关联模式,其中使用阿片类止痛药物来应对情绪/寻求快感与结果变量的效应量最大。
结果强调了超越使用本身进行研究的重要性,并研究患有癌症的 AYAs 如何以及为何使用阿片类药物,以了解潜在的负面后果。