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:6
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作者:
Harsanyi, Hannah
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机构:
Univ Calgary, Dept Community Hlth Sci, Calgary, AB T2N 1N4, CanadaUniv Calgary, Dept Community Hlth Sci, Calgary, AB T2N 1N4, Canada
Harsanyi, Hannah
[1
]
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Cuthbert, Colleen
[2
]
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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
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.
机构:
Brigham & Womens Hosp, Dept Emergency Med, 75 Francis St, Boston, MA 02115 USA
Dana Faber Canc Inst, Dept Psychosocial Oncol & Palliat Care, Boston, MA USA
Harvard Med Sch, Boston, MA 02115 USABrigham & Womens Hosp, Dept Emergency Med, 75 Francis St, Boston, MA 02115 USA
Azizoddin, Desiree R.
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Knoerl, Robert
Adam, Rosalind
论文数: 0引用数: 0
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机构:
Univ Aberdeen, Inst Appl Hlth Sci, Aberdeen, ScotlandBrigham & Womens Hosp, Dept Emergency Med, 75 Francis St, Boston, MA 02115 USA
Adam, Rosalind
Kessler, Daniela
论文数: 0引用数: 0
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机构:
Dana Faber Canc Inst, Div Populat Sci, Dept Med Oncol, Boston, MA USABrigham & Womens Hosp, Dept Emergency Med, 75 Francis St, Boston, MA 02115 USA
Kessler, Daniela
Tulsky, James A.
论文数: 0引用数: 0
h-index: 0
机构:
Dana Faber Canc Inst, Dept Psychosocial Oncol & Palliat Care, Boston, MA USA
Harvard Med Sch, Boston, MA 02115 USA
Brigham & Womens Hosp, Dept Med, Div Palliat Med, 75 Francis St, Boston, MA 02115 USABrigham & Womens Hosp, Dept Emergency Med, 75 Francis St, Boston, MA 02115 USA
Tulsky, James A.
Edwards, Robert R.
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h-index: 0
机构:
Brigham & Womens Hosp, Dept Anesthesiol Perioperat & Pain Med, 75 Francis St, Boston, MA 02115 USABrigham & Womens Hosp, Dept Emergency Med, 75 Francis St, Boston, MA 02115 USA
Edwards, Robert R.
Enzinger, Andrea C.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Med Sch, Boston, MA 02115 USA
Dana Faber Canc Inst, Div Populat Sci, Dept Med Oncol, Boston, MA USABrigham & Womens Hosp, Dept Emergency Med, 75 Francis St, Boston, MA 02115 USA
机构:
Swansea Univ, Global Drug Policy Observ, Swansea, Wales
Ctr Res & Informat Subst Abuse, Uyo, Nigeria
Ctr Res & Informat Subst Abuse, Univ PO 4230, Uyo, NigeriaSwansea Univ, Global Drug Policy Observ, Swansea, Wales
机构:
Univ Kentucky, Coll Med, Dept Internal Med, Div Palliat & Support Care, CTW Bldg Room 308,900 Rose St, Lexington, KY 40508 USAUniv Kentucky, Coll Med, Dept Internal Med, Div Palliat & Support Care, CTW Bldg Room 308,900 Rose St, Lexington, KY 40508 USA
Nickels, Katrina
Kullgren, Justin
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Wexner Med Ctr, James Canc Hosp, Columbus, OH USAUniv Kentucky, Coll Med, Dept Internal Med, Div Palliat & Support Care, CTW Bldg Room 308,900 Rose St, Lexington, KY 40508 USA
Kullgren, Justin
Mitchell, Megan T.
论文数: 0引用数: 0
h-index: 0
机构:
UK HealthCare Albert B Chandler Hosp, Dept Pharm, Lexington, KY USAUniv Kentucky, Coll Med, Dept Internal Med, Div Palliat & Support Care, CTW Bldg Room 308,900 Rose St, Lexington, KY 40508 USA
Mitchell, Megan T.
Carter, Marianne
论文数: 0引用数: 0
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UK HealthCare Albert B Chandler Hosp, Dept Pharm, Lexington, KY USAUniv Kentucky, Coll Med, Dept Internal Med, Div Palliat & Support Care, CTW Bldg Room 308,900 Rose St, Lexington, KY 40508 USA
Carter, Marianne
Kasberg, Brandon
论文数: 0引用数: 0
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UK HealthCare Albert B Chandler Hosp, Dept Pharm, Lexington, KY USAUniv Kentucky, Coll Med, Dept Internal Med, Div Palliat & Support Care, CTW Bldg Room 308,900 Rose St, Lexington, KY 40508 USA
Kasberg, Brandon
Holbein, Monika
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Penn State Hlth, Dept Internal Med, Sect Palliat Care, Hershey, PA USAUniv Kentucky, Coll Med, Dept Internal Med, Div Palliat & Support Care, CTW Bldg Room 308,900 Rose St, Lexington, KY 40508 USA
Holbein, Monika
Gamble, Alex
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Stanford Univ, Dept Primary Care & Populat Hlth, Palliat Med, Stanford, CA USAUniv Kentucky, Coll Med, Dept Internal Med, Div Palliat & Support Care, CTW Bldg Room 308,900 Rose St, Lexington, KY 40508 USA
Gamble, Alex
Thompson, Benjamin
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Univ South Carolina, Prisma Hlth, Dept Internal Med, Div Palliat Care, Columbia, SC USAUniv Kentucky, Coll Med, Dept Internal Med, Div Palliat & Support Care, CTW Bldg Room 308,900 Rose St, Lexington, KY 40508 USA
Thompson, Benjamin
Koolwal, Astha
论文数: 0引用数: 0
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Vassar Bros Med Ctr, Dept Internal Med, Poughkeepsie, NY USAUniv Kentucky, Coll Med, Dept Internal Med, Div Palliat & Support Care, CTW Bldg Room 308,900 Rose St, Lexington, KY 40508 USA
Koolwal, Astha
Ho, J. Janet
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机构:
Univ Calif San Francisco, Dept Med Palliat Care & Addict Med, San Francisco, CA USAUniv Kentucky, Coll Med, Dept Internal Med, Div Palliat & Support Care, CTW Bldg Room 308,900 Rose St, Lexington, KY 40508 USA
机构:
Univ Indonesia, Fac Med, Dept Pharmacol & Therapeut, Jl Salemba 6, Jakarta 10430, IndonesiaUniv Indonesia, Fac Med, Dept Pharmacol & Therapeut, Jl Salemba 6, Jakarta 10430, Indonesia
Setiabudy, Rianto
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Irawan, Cosphiadi
Sudoyo, Aru W.
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Univ Indonesia, Fac Med, Dept Internal Med, Cipto Mangunkusumo Hosp, Jakarta 10430, IndonesiaUniv Indonesia, Fac Med, Dept Pharmacol & Therapeut, Jl Salemba 6, Jakarta 10430, Indonesia
机构:
Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA
Seattle Canc Care Alliance, Dept Psychosocial Oncol, 825 Eastlake Ave E,MS K2-231,POB 19023, Seattle, WA 98109 USAUniv Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA
Bates, Nicole
Bello, Jennifer K.
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St Louis Univ, Dept Family & Community Med, Sch Med, 1008 S Spring,SLUCare Acad Pavil, St Louis, MO 63110 USAUniv Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA
Bello, Jennifer K.
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Osazuwa-Peters, Nosayaba
Sullivan, Mark D.
论文数: 0引用数: 0
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Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USAUniv Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA
Sullivan, Mark D.
Scherrer, Jeffrey F.
论文数: 0引用数: 0
h-index: 0
机构:
St Louis Univ, Dept Family & Community Med, Sch Med, 1008 S Spring,SLUCare Acad Pavil, St Louis, MO 63110 USA
St Louis Univ, Sch Med, Adv Hlth Data AHEAD Res Inst, 3545 Lafayette Ave, St Louis, MO 63104 USAUniv Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA
机构:
Drexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USADrexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USA
Bradt, Joke
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Leader, Amy
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Worster, Brooke
Myers-Coffman, Kate
论文数: 0引用数: 0
h-index: 0
机构:
Drexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USADrexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USA
Myers-Coffman, Kate
Bryl, Karolina
论文数: 0引用数: 0
h-index: 0
机构:
Drexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USADrexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USA
Bryl, Karolina
Biondo, Jacelyn
论文数: 0引用数: 0
h-index: 0
机构:
Drexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USADrexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USA
Biondo, Jacelyn
Schneible, Brigette
论文数: 0引用数: 0
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Drexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USADrexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USA
Schneible, Brigette
Cottone, Carrie
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Drexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USADrexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USA
Cottone, Carrie
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Selvan, Preethi
Zhang, Fengqing
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机构:
Drexel Univ, Coll Arts & Sci, Dept Psychol & Brain Sci, Philadelphia, PA USADrexel Univ, Coll Nursing & Hlth Profess, Dept Creat Arts Therapies, Philadelphia, PA 19104 USA