July 13, 2024

Cancer Patients with Opioid Use Disorder Face Challenges in Receiving Treatment, Says Study

The article, written by researchers from the University of Pittsburgh, highlights the difficulties faced by patients in accessing methadone, a medication used to treat opioid use disorder, after they receive a cancer diagnosis.

The authors discuss the case of a patient who had been taking methadone for many years and was later diagnosed with head and neck cancer. Prior to his cancer diagnosis, the patient was given a 28-day supply of take-home methadone doses, which he self-administered and returned to the clinic for monitoring and refills. However, when the patient’s oncologist prescribed oxycodone for his cancer pain, which was detected in a routine urine test, the patient’s take-home privileges for methadone were revoked. This posed a significant challenge for the patient, as he was required to return to daily visits at the methadone clinic while undergoing chemotherapy and oncology appointments.

The case of this patient is not unique, according to senior author Jessica Merlin, M.D., Ph.D., Director of Pitt’s Challenges in Managing and Preventing Pain Clinical Research Center. While there are effective treatments available for opioid use disorder, integrating them with cancer treatment and improving patient access is a complex issue.

Methadone is widely recognized as one of the most effective treatments for opioid use disorder. However, its distribution is tightly controlled, with most patients having to visit a clinic daily to receive their dose. A cancer diagnosis further complicates the situation, creating variability among clinicians in terms of how and when to prescribe methadone for cancer patients with opioid use disorder.

Research conducted by lead author Katie F. Jones, Ph.D., in collaboration with Merlin, indicated that healthcare providers have concerns about the legal and safety implications of prescribing methadone to patients with cancer and opioid use disorder. Providers are hesitant to prescribe methadone due to the current system’s restrictions.

The patient’s story highlights the potential impact of the proposed Modernizing Opioid Treatment Act (MOTA), which aims to expand access to methadone by allowing more healthcare providers to prescribe it and increasing the locations where it can be dispensed. MOTA would eliminate the need for daily visits to a methadone clinic, making treatment more accessible to patients.

Currently, methadone is available in about 49% of U.S. census tracts. However, if MOTA is implemented, access could expand to approximately 63% of census tracts, as suggested by co-author Paul Joudrey, M.D., Assistant Professor in the Pitt School of Medicine in a recent Health Affairs Scholar paper.

Jessica Merlin emphasizes the urgency to improve access and integrate treatment for opioid use disorder into the larger healthcare system, especially considering the increasing number of patients who have been on methadone for years and are now developing serious illnesses. As the opioid epidemic continues in the United States, it is crucial to address the unique challenges faced by cancer patients with opioid use disorder and find ways to improve their access to appropriate treatment.

1. Source: Coherent Market Insights, Public sources, Desk research
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