Safe Opioid Use: Management of Opioid-Related Adverse Effects and Aberrant Behaviors

Hematol Oncol Clin North Am. 2018 Jun;32(3):387-403. doi: 10.1016/j.hoc.2018.01.003.

Abstract

Opioids are highly effective for cancer pain but are associated with multiple adverse effects and risk of addiction. This article provides a synopsis on the management of various opioid-related adverse effects and strategies to minimize aberrant opioid use in patients who have cancer. Many adverse effects can be effectively managed. Some patients on chronic opioid therapy may demonstrate aberrant behaviors suggestive of opioid misuse or diversion. Through intensive education, longitudinal monitoring, early identification, and timely management, clinicians can optimize the risk to benefit ratio to support safe opioid use.

Keywords: Aberrant behavior; Adverse effects; Cancer; Constipation; Nausea; Opioid; Sedation; Tolerance.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Analgesics, Opioid* / adverse effects
  • Analgesics, Opioid* / therapeutic use
  • Humans
  • Mental Disorders* / chemically induced
  • Mental Disorders* / prevention & control
  • Narcotics* / adverse effects
  • Narcotics* / therapeutic use
  • Neoplasms* / drug therapy
  • Neoplasms* / physiopathology
  • Opioid-Related Disorders / prevention & control*
  • Pain* / drug therapy
  • Pain* / physiopathology

Substances

  • Analgesics, Opioid
  • Narcotics