Association between pain medication misuse, psychological distress, and opioid use disorder among adults with lifetime cancer diagnosis in the United States.
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PURPOSE: Opioid use disorder (OUD) is a critical public health concern in the United States, further complicated in cancer patients who often require opioids for pain management. This study aims to identify predictors of OUD among adults with lifetime cancer in the United States. METHODS: A cross-sectional analysis was conducted using data from the 2022 National Survey on Drug Use and Health (NSDUH). A total of 1,948 cancer respondents were included. Multivariable logistic regression models were employed to examine the association between OUD and predictors such as pain medication misuse, psychological distress, and SUD history, while adjusting for socio-demographic factors. RESULTS: The prevalence of OUD among cancer patients was 3.0%, with 9% reporting pain medication misuse. Respondents who misused pain medications were 11.3 times more likely to have an OUD (adjusted odds ratio [aOR]: 11.3, 95% CI: 4.07-31.3). High to very high psychological distress was associated with a significant increase in odds of OUD compared to low or no distress, [aOR] 10.8 (95% CI: 1.89-61.6). No significant association was observed between a history of SUD treatment and OUD. CONCLUSION: Cancer patients remain at considerable risk for OUD, driven by pain medication misuse and psychological distress. These findings underscore the need for comprehensive strategies integrating opioid management, mental health support, and early identification of at-risk individuals. A multidisciplinary approach is essential to mitigate the dual challenges of effective cancer pain management and the prevention of OUD.