Clinicians who treat cancer-related pain with opioids often encounter patients who also use stimulant drugs like methamphetamine and cocaine. However, until now, there have been no established guidelines to help healthcare professionals navigate these complex situations. Fortunately, a recent study published in the journal Cancer has identified expert consensus on methods for managing opioids in patients with advanced cancer who use nonmedical stimulants.
In the study, researchers conducted two modified Delphi panels involving a total of 120 palliative care addiction experts. The first panel included patients with a short prognosis of weeks to months, while the second panel focused on patients with a longer prognosis of months to years. The experts were asked to rate the appropriateness of various management strategies using a 9-point Likert scale.
The findings revealed that regardless of the prognosis, it is considered safe and appropriate for patients with advanced cancer who use methamphetamines or cocaine to continue opioid use while increasing clinical monitoring. This approach prioritizes pain control and gives healthcare professionals more time to develop personalized harm-reduction plans for these patients. The study also showed that transitioning to buprenorphine/naloxone treatment was deemed inappropriate for patients with a short prognosis, with undetermined appropriateness for those with a longer prognosis.
These guidelines are a crucial step towards providing better care for cancer patients who use stimulant drugs. By implementing these recommendations, clinicians can ensure that patients receive optimal pain management while addressing the complexities associated with nonmedical stimulant use.
Frequently Asked Questions (FAQ)
Q: What is the significance of this study?
A: This study provides much-needed guidelines on how clinicians should manage opioids in cancer patients who also use stimulant drugs. It allows healthcare professionals to prioritize pain control while addressing the unique challenges associated with nonmedical stimulant use.
Q: Why is it important to continue opioid use in these patients?
A: The study found it safe and appropriate for patients with advanced cancer who use methamphetamines or cocaine to continue opioid use while increasing clinical monitoring. This approach ensures that patients have adequate pain control and gives healthcare professionals more time to develop personalized harm-reduction strategies.
Q: Is transitioning to buprenorphine/naloxone treatment recommended?
A: The study deemed transitioning to buprenorphine/naloxone treatment inappropriate for patients with a short prognosis and of undetermined appropriateness for those with a longer prognosis. Further research is needed to determine the best approach for these patients.