The American Association of Clinical Oncology (ASCO) released a very important new policy statement that details their position surrounding the prescribing of opioids to cancer patients. This issue has taken the forefront of controversy as our society increasingly becomes concerned about the overuse of prescription opioids, sometimes leaving out the very specific needs of cancer patients.
In the statement, ASCO has indicated that they support the concern and efforts to prevent prescription drug abuse. However, ASCO has expressed concerned for cancer patients with legitimate need for these drugs and says that it will work to protect access to appropriate medical opioid therapy for patients with cancer without physicians being concerned about being harassed by government officials.
ASCO’s statement of policy tries to balance the very real public health concerns against the very significant needs of advanced cancer patients and survivors.
The statement makes it clear that cancer patients should be considered a special population and should be largely exempt from regulations restricting access to, or limiting doses of prescription opioids in recognition of the unique nature of their disease, its treatment, and potentially life-long adverse health effects from having had cancer.
Given this, ASCO believes that the current system for tracking heavy prescribers of opioids should not continue as currently structured. They believe that Providers who treat cancer-related pain should be able to prescribe relatively large numbers of opioids or provide multiple controlled drugs at relatively high doses without falling into the net of suspicion of government officials. ASCO believes that government efforts to identify problematic prescribing patterns must consider the provider’s specialty, sub-specialization, patient populations, and other factors that legitimately influence prescribing patterns.
ASCO also believes that after the initial screening and assessment of patients with cancer, the treating physician should determine the type and timing of subsequent assessments. Compliance tools following an initial prescription may be valuable, but should not be mandatory for all cancer patients receiving opioids.
The statement also says that individuals with an opioid-related disorder should have a rapid and appropriate assessment, diagnosis, and treatment, regardless of their payer or geographic setting. Treatment for this type of disorder should be made available to all in need without any delay or penalty.
Naloxone is a life-saving medication in cases of opioid overdose and should be easily available to everyone, including cancer patient’s caregivers. Caregivers should be provided with Naloxone and given instructions on its correct use, with particular attention paid to timing the administration of the medication, as well as distinguishing the symptoms of an opioid overdose from those of advanced cancer.
ASCO is concerned about the proliferation of unused or no longer needed drugs and supports a formal, structured take back program in order to decrease drug availability outside of the original prescribed need. Authorized collection sites should be readily available to all patients no matter where they are located.
ASCO’s statement speaks to the heart of concerns that many patients with advanced cancer have about pain palliation. We are very aware of the abuse of these drugs in the general population, but are also very concerned about our ability to maintain a decent quality of life as we continue on in our journey. No cancer survivor should have to deal with pain.
Thank you ASCO for a clear and concise statement that makes sense.