The Stigma Surrounding Opioid Use as a Barrier to Cancer-Pain Management: An Overview of Experiences with Fear, Shame, and Poorly Controlled Pain in the Context of Advanced Cancer

被引:12
作者
Harsanyi, Hannah [1 ]
Cuthbert, Colleen [2 ]
Schulte, Fiona [3 ]
机构
[1] Univ Calgary, Dept Community Hlth Sci, Calgary, AB T2N 1N4, Canada
[2] Univ Calgary, Fac Nursing, Calgary, AB T2N 1N4, Canada
[3] Univ Calgary, Dept Oncol, Div Psychosocial Oncol, Calgary, AB T2N 1N4, Canada
关键词
cancer pain; opioid use; advanced cancer; symptom management; stigma; STANDARD ONCOLOGY CARE; PALLIATIVE CARE; USE DISORDER; PREVALENCE; ATTITUDES; THERAPY; INTERVENTIONS; PREDICTORS; SYMPTOMS; QUALITY;
D O I
10.3390/curroncol30060437
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Cancer-related pain affects a majority of patients with advanced cancer and is often undertreated. The treatment of this pain is largely reliant on the use of opioids, which are essential medicines for symptom management and the maintenance of quality of life (QoL) for patients with advanced cancer. While there are cancer-specific guidelines for the treatment of pain, widespread publication and policy changes in response to the opioid epidemic have drastically impacted perceptions of opioid use. This overview therefore aims to investigate how manifestations of opioid stigma impact pain management in cancer settings, with an emphasis on the experiences of patients with advanced cancer. Opioid use has been widely stigmatized in multiple domains, including public, healthcare, and patient populations. Physician hesitancy in prescribing and pharmacist vigilance in dispensing were identified as barriers to optimal pain management, and may contribute to stigma in the context of advanced cancer. Evidence in the literature suggests that opioid stigma may result in patient deviations from prescription instructions, which generally leads to pain undertreatment. Patients reflected on experiencing shame and fear surrounding their prescription opioid use and feeling uncomfortable communicating with their healthcare providers on these topics. Our findings indicate that future work is required to educate patients and providers in order to de-stigmatize opioid use. Through alleviating stigma, patients may be better able to make decisions regarding their pain management which lead to freedom from cancer-related pain and improved QoL.
引用
收藏
页码:5835 / 5848
页数:14
相关论文
共 124 条
[1]   Changes in Opioid Prescribing Patterns Among Generalists and Oncologists for Medicare Part D Beneficiaries From 2013 to 2017 [J].
Agarwal, Ankit ;
Roberts, Andrew ;
Dusetzina, Stacie B. ;
Royce, Trevor J. .
JAMA ONCOLOGY, 2020, 6 (08) :1271-1274
[2]   Law, Culture, and Fear: A Qualitative Study of Health Professionals' Perceptions of Narcotic Use Related to Cancer Pain [J].
Al-Masri, Dania ;
Wilbur, Kerry ;
Elazzazy, Shereen ;
Hassan, Azza A. ;
Wilby, Kyle J. .
JOURNAL OF PAIN & PALLIATIVE CARE PHARMACOTHERAPY, 2020, 34 (02) :55-62
[3]   Opioid Misuse and Abuse: Risk Assessment and Management in Patients with Cancer Pain [J].
Anghelescu, Doralina L. ;
Ehrentraut, Jennifer Harman ;
Faughnan, Lane G. .
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK, 2013, 11 (08) :1023-1031
[4]  
[Anonymous], 2018, WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents
[5]   Health Care Provider Attitudes, Beliefs, and Perceived Confidence in Managing Patients With Cancer Pain and Nonmedical Opioid Use [J].
Arthur, Joseph ;
Edwards, Tonya ;
Lu, Zhanni ;
Hui, David ;
Fellman, Bryan ;
Bruera, Eduardo .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2021, 61 (01) :128-+
[6]   Cancer pain self-management in the context of a national opioid epidemic: Experiences of patients with advanced cancer using opioids [J].
Azizoddin, Desiree R. ;
Knoerl, Robert ;
Adam, Rosalind ;
Kessler, Daniela ;
Tulsky, James A. ;
Edwards, Robert R. ;
Enzinger, Andrea C. .
CANCER, 2021, 127 (17) :3239-3245
[7]   PSYCHOLOGICAL SYMPTOMS IN ADVANCED CANCER [J].
Bail, Jennifer R. ;
Traeger, Lara ;
Pirl, William F. ;
Bakitas, Marie A. .
SEMINARS IN ONCOLOGY NURSING, 2018, 34 (03) :241-251
[8]   Opioid misuse in oncology pain patients [J].
Ballantyne J.C. .
Current Pain and Headache Reports, 2007, 11 (4) :276-282
[9]   Pain, physical dependence and pseudoaddiction: Redefining addiction for 'nice' people? [J].
Bell, Kirsten ;
Salmon, Amy .
INTERNATIONAL JOURNAL OF DRUG POLICY, 2009, 20 (02) :170-178
[10]   Stigma: Advances in Theory and Research [J].
Bos, Arjan E. R. ;
Pryor, John B. ;
Reeder, Glenn D. ;
Stutterheim, Sarah E. .
BASIC AND APPLIED SOCIAL PSYCHOLOGY, 2013, 35 (01) :1-9