Grant Awarded to Address Prescription and Management of Opioids for Patients of Cancer

December 19, 2019

Lawrence Feldman, MD, of the division of hematology and oncology in the department of medicine at the University of Illinois at Chicago, and a team of researchers received a grant to explore addiction, abuse, and new ways to prescribe opioids.

A grant from the Coleman Foundation was awarded to the University of Illinois at Chicago (UIC) to develop a program for the prescription and management of opioids for patients with cancer, a UIC press release announced.

According to the press release, the $300,000 grant-funded program was awarded to Lawrence Feldman, MD, UIC professor of hematology/oncology at the College of Medicine and principal investigator, and his team of researchers for their work with addiction experts at UI Health Mile Square Health Center to focus on lung and head and neck cancer. The focus remains in this area of cancer because “those patients have a higher rate of previous or current substance use disorders.”

“There's been more concern about not prescribing opioids because of the concern over addiction and abuse,” Feldman said. “And so that's kind of caused us to rethink how we treat chronic cancer pain and opioid use in our cancer patients.”

The shifting paradigm over the recent years has caused professionals to rethink exactly how they see pain management overall, and how to prescribe opioids in accordance with that pain, according to Dr. Feldman. With this program, the goal is to screen patients for information regarding their potential to develop opioid use disorder to ultimately prevent that development.

The team of researchers are focusing on 3 subgroups of patients, Dr. Feldman detailed. The first group consists of patients who are free of their disease, but still remain on narcotics. The researchers would also focus on screening patients up front in the second group to determine their risk of developing an opioid use disorder. Finally, patients who are diagnosed with cancer and are already having issues with addiction would comprise the third group.

“Looking at these 3 different populations of patients, we hope to develop sort of an algorithm and standard treatment guidelines that can help clinicians and oncologists get a better handle on how to manage these patients,” explained Dr. Feldman.

Dr. Feldman and his team working on the grant, including Tamara Hamlish, PhD; Michael Huber, MD; Phil Maes, RN; Jovonne Owens, NP; Mary Pasquinelli NP; Nicole Gastala, MD; and Jason Tuite, MSW, want to help physicians going forward to identify these personality groups and be able to determine the best possible course of action to manage and treat these patients.

In the past, the pain experienced by patients with cancer was the top priority in the decision to prescribe opioids, explained Feldman. Many doctors did not worry about the addictive side of the equation because they were taught to “treat pain as like the fifth vital sign and get their pain alleviated.”

The changing narrative in the media and the opioid epidemic sweeping the nation have caused professionals to reevaluate how they go about prescribing opioids. No longer can professionals simply prescribe opioids whenever they are requested.

“We more or less focused on only treating the cancer,” said Feldman. “We really need to focus on the actual causes of the pain, and how much of this pain is not really pain, but addiction.”

Luckily for Feldman, he feels he has a great team in place to not only learn more about the issue but provide enough information to give valuable advice to professionals in this situation.

“I’m really dependent and thankful that we have such a strong team for this project,” explained Feldman. “We feel we're in good position to figure out what the best approach is for these patients and to make some recommendations.”

References:

Program to address opioid prescribing for lung, head and neck cancer patients [press release]. Palmyra, VA: Newswire; December 2, 2019. https://www.newswise.com/articles/program-to-address-opioid-prescribing-for-lung-head-and-neck-cancer-patients?sc=sphr&xy=10021790. Accessed December 13, 2019.