Prevalence and correlates of high-dose opioid use among survivors of head and neck cancer

Background: We characterized prescription opioid medication use up to 2 years following the head and neck cancer (HNC) diagnosis and examined associations with moderate or high daily opioid prescription dose. Methods: Using administrative data from Veterans Health Administration, we conducted a retrospective cohort analysis of 5522 Veterans treated for cancers of the upper aerodigestive tract between 2012 and 2019. Data included cancer diagnosis and treatments, pain severity, prescription opioid characteristics, demographics, and other clinical factors. Results: Two years post-HNC, 7.8% (n = 428) were receiving moderate or high-dose opioid therapy. Patients with at least moderate pain (18%, n = 996) had 2.48 times higher odds (95% CI = 1.94–3.09, p < 0.001) to be prescribed a moderate opioid dose or higher at 2 years post diagnosis. Conclusions: Survivors of HNC with at least moderate pain were at elevated risk of continued use of moderate and high dose opioids.