In study findings presented at the 2020 San Antonio Breast Cancer Symposium, women who received a mastectomy and reconstructive surgery after a diagnosis of breast cancer were found to be at a greater risk of chronic controlled substance use, per media reports.
The session was presented by Jacob Cogan, MD, an internist specializing in hematology and oncology in New York and lead author of the study.
Cogan and fellow researchers reviewed healthcare claims data for women over the age of 18 who had undergone a mastectomy and reconstruction between 2008 and 2017. Prescriptions for opioid and sedative-hypnotic drugs were provided in three periods:
- Pre-operation (Between 1 year and 1 month prior to surgery)
- Peri-operative (Between 1 month prior to surgery and 90 days post-surgery)
- Post-operation (Between 90 days and 1 year post-surgery)
The researchers removed patients who filled prescriptions in the first period from the study. Of the remaining patients, 25,270 women were identified as opioid-naïve and 27,651 were sedative-hypnotic-naïve. The study found that 13.1% of opioid-naïve patients became new chronic users, and 6.6% of previously sedative-hypnotic-naïve patients became persistent users. Removing patients who had never previously filled or received prescriptions post-surgery, the rates increased to 17.5% and 17.0%, respectively.
Patients under the age of 60, those with Medicaid insurance, those who have undergone chemotherapy/radiation treatment, and those who live in the Southern region of the U.S. were also found to be at greater risk.
Cogan told attendees of the conference that the findings suggest that physicians should explicitly ask patients about continued use of opioids and sedative-hypnotics in follow-up visits, and encourage patients to safely dispose of the medications once they are finished with them.