ArticleJAMA oncology2022
Changes in Opioid Prescriptions and Potential Misuse and Substance Use Disorders Among Childhood Cancer Survivors Following the 2016 Opioid Prescribing Guideline.
Article in JAMA oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Development of prediction models for perioperative opioid needs in laparoscopic cholecystectomy patients: A machine-learning approach.Surgery open science · 2026Article
- Acetaminophen and Acetaminophen-Opioid Combination Prescribing Trends Among Hospitalized Children, Adolescents, and Young Adults with Cancer.Pharmacological research. Reports · 2025Article
- Mental health service utilization in publicly insured survivors of childhood cancer: a claims-based analysis.JNCI cancer spectrum · 2025Article
- A Narrative Review of Pain in Pediatric Oncology: The Opioid Option.Paediatric drugs · 2024Review
- Mental Health Care Utilization Among Parents of Children With Cancer.JAMA network open · 2024Article
- Development of an enhanced recovery after surgery program for pediatric solid tumors.Frontiers in surgery · 2024Article
- Utilization of cardiac tests in anthracycline-treated cancer survivors differs between young adults and children: A claims-based analysis.Cancer medicine · 2023Article
- The effect of cancer exemption in mandatory-access prescription drug monitoring programs among oncologists.JNCI cancer spectrum · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: The Centers for Disease Control and Prevention (CDC) released an opioid-prescribing guideline in March 2016. Little is known about the guideline's potential effects on childhood cancer survivors, a population at high risk for pain. Objective: To examine changes in opioid prescriptions and potential misuse/substance use disorders (SUD) among childhood cancer survivors and peers without cancer following the guideline release. Design, Setting, and Participants: In this cohort study using the MarketScan Commercial Claims and Encounters Database, 8969 survivors who completed treatment for hematologic, central nervous system, bone, or gonadal cancers (aged ≤21 years at diagnosis) from 2009 to 2018 and 44 845 age-matched, sex-matched, and region-matched individuals without cancer were identified. With data aggregated based on the quarter-year of survivors' treatment completion, interrupted time series analyses were conducted in this cohort study to estimate the immediate (level) change and change in time trend (trend change) for each outcome after the guideline release, accounting for autocorrelation. Data were analyzed from September 2021 to April 2022. Exposures: Release of the CDC opioid-prescribing guideline. Main Outcomes and Measures: Outcomes included any opioid prescription and any indicator for potential misuse/SUD within 1 year following completion of treatment. Results: This study included 8969 childhood cancer survivors (mean [SD] age, 13.7 [6.2] years old; 3814 [42.5%] female patients) and 44 845 peers without cancer (mean [SD] age, 13.7 [6.2] years old; 19 070 [42.5%] female patients). Before the guideline release, the opioid prescription rate (21.1% vs 7.2%) and rate of potential misuse/SUD (5.6% vs 1.9%) were higher among survivors than peers without cancer. After the guideline release, the trend in opioid prescription rate declined among survivors (trend change, -1.1 percentage points [ppt]; P < .001; 95% CI, -1.5 to -0.7). Survivors also experienced an immediate level decrease (-2.1 ppt; P = .04; 95% CI, -4.2 to -0.1) and a decreasing trend (trend change, -0.4 ppt; P = .009; 95% CI, -0.6 to -0.1) in rate of potential misuse/SUD. Peers without cancer experienced decreasing trends in opioid prescription rate (trend change, -0.3 ppt; P < .001; 95% CI, -0.5 to -0.1) and rate of potential misuse/SUD (trend change, -0.1 ppt; P = .03; 95% CI, -0.1 to -0.01). By 2 years after the guideline release, relative reductions in opioid prescription rate and rate of potential misuse/SUD among survivors were 36.7% and 65.4%, respectively, with peers without cancer experiencing smaller reductions (15.9% and 29.9%). Conclusions and Relevance: In this cohort study, the opioid prescription rate and rate of potential misuse/SUD declined among both survivors and peers without cancer following the CDC guideline release, with survivors experiencing greater reductions. More research is needed to understand the guideline's potential effects on access to opioids required for pain control among childhood cancer survivors.
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