The purpose of this report is to illustrate the importance of assessing for family, peer, and personal substance abuse risk factors in the case of a young adult with cancer-related pain and behaviors potentially indicative of opioid misuse (OM). A thorough clinical interview and an OM screening measure revealed important information about the patient's family and social environment. Based on this information, the treatment team acted quickly to prevent additional aberrant opioid-associated behaviors (AOBs). Despite these efforts, additional AOBs occurred; however, the case highlights the importance of family and social environments for adolescents and young adults with cancer-related pain.
Get full access to this article
View all access options for this article.
References
1.
BleyerWA, VinyA, BarrR. Introduction. In: BleyerWA, O'LearyMC, BarrRD, RiesLAG, AndersonB, ValleCG, SheafferJW (Eds). Cancer epidemiology in older adolescents and adults 15 to 29 years of age: seer incidence and survival: 1975–2000. Bethesda: National Cancer Institute; 2006; pp. 1–14.
KeeganTHM, RiesLAG, BarrRD, et al.Comparison of cancer survival trends in the United States of adolescents and young adults with those in children and older adults. Cancer. 2016; 122(7):1009–16.
4.
ForgeronPA, FinleyA, ArnaoutM. Pediatric pain prevalence and parents' attitudes at a cancer hospital in Jordan. J Pain Symptom Manage. 2006; 31(5):440–8.
5.
LjungmanG, GordhT, SörensenS, KreugerA. Pain variations during cancer treatment in children: a descriptive survey. Pediatr Hematol Oncol. 2000; 17(3):211–21.
6.
MiserAW, DothageJA, WesleyRA, MiserJS. The prevalence of pain in a pediatric and young adult cancer population. Pain. 1987; 29(1):73–83.
7.
EhrentrautJH, KernKD, LongSA, et al.Opioid misuse behaviors in adolescents and young adults in a hematology/oncology setting. J Pediatr Psychol. 2014; 39(10):1149–60.
8.
BallantyneJC. Opioid analgesia: perspectives on right use and utility. Pain Physician. 2007; 10(3):479–91.
BernsteinD, StowellAW, HaggardR, et al.Complex interplay of participants in opioid therapy. Pract Pain Manag. 2007; 7:10–36.
11.
MiechR, JohnstonL, O'MalleyPM, et al.Prescription opioids in adolescence and future opioid misuse. Pediatrics. 2015; 136:e1169–77.
12.
AnghelescuDL, EhrentrautJH, FaughnanLG. Opioid misuse and abuse: risk assessment and management in patients with cancer pain. J Natl Compr Canc Netw. 2013; 11(8):1023–31.
13.
PassikSD, PortenoyRK, RickettsPL. Substance abuse issues in cancer patients. Part 1: prevalence and diagnosis. Oncology., 1998; 12(4):517–21.
14.
PergolizziJVJr., GhariboC, PassikS, et al.Dynamic risk factors in the misuse of opioid analgesics. J Psychosom Res., 2012; 72(6):443–51.
15.
PeckKR, EhrentrautJH, AnghelescuDL. Risk factors for opioid misuse in adolescents and young adults with focus on oncology settings. J Opioid Manag. 2016; 12:205–16.
16.
BarclayJS, OwensJE, BlackhallLJ. Screening for substance abuse risk in cancer patients using the Opioid Risk Tool and urine drug screen. Support Care Cancer. 2014; 22(7):1883–8.
17.
MichnaE, RossEL, HynesWL, et al.Predicting aberrant drug behavior in patients treated for chronic pain: importance of abuse history. J Pain Symptom Manage. 2004; 28(3):250–8.
18.
KoyyalaguntaD, BrueraE, AignerC, et al.Risk stratification of opioid misuse among patients with cancer pain using the SOAPP-SF. Pain Med. 2013; 14(5):667–75.
19.
ButlerSF, BudmanSH, FernandezKC, et al.Cross-validation of a screener to predict opioid misuse in chronic pain patients (SOAPP-R). J Addict Med. 2009; 3(2):66–73.
20.
ButlerSF, BudmanSH, FernandezK, JamisonRN. Validation of a screener and opioid assessment measure for patients with chronic pain. Pain. 2004; 112(1–2):65–75.
21.
ChouR, FanciulloGJ, FinePG, et al.Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009; 10(2):113–30.
22.
ThienprayoonR, PorterK, TateM, et al.Risk stratification for opioid misuse in children, adolescents, and young adults: a quality improvement project. Pediatrics. 2017; 139(1):e2 0160258.
23.
ButlerSF, BudmanSH, FernandezKC, et al.Development and validation of the current opioid misuse measure. Pain. 2007; 130(1–2):144–56.
24.
SullivanMJL, BishopSR, PivikJ. The pain catastrophizing scale: development and validation. Psychol Assess. 1995; 7(4):524–32.
25.
ClarkME, GirondaRJ, YoungRW. Development and validation of the pain outcomes questionnaire–VA. J Rehabil Res Dev. 2003; 40(5):381–96.
