Opioid use disorder among females with breast cancer: A comprehensive analysis of prevalence in the United States and associated factors.

Abstract

1118 Background: Patients with breast cancer (BC) are frequently prescribed opioids for pain management, placing them at risk of opioid use disorder (OUD). This study analyzes the prevalence of OUD and identifies factors contributing to its risk among BC patients in the United States. Methods: We conducted a retrospective analysis using the National Inpatient Sample (NIS) database, a Healthcare Cost and Utilization Project (HCUP) component. Females with BC were identified through ICD-10 codes. The Cochran-Armitage trend test assessed OUD prevalence trends from 2016 to 2022. Multivariable regression models estimated the impact of multiple patient demographics and comorbidities on the presence of OUD. Results: Among 1,189,884 females aged≥18 with BC, 2.3% (27,500) had OUD. The mean age of OUD patients was 58.38 years, compared to 64.46 years in the non-OUD cohort. OUD prevalence was highest in those aged 18–50 years (3.8%), followed by 51–60 years (3.0%), and lowest in those > 60 years (1.7%). Between 2016 and 2020, OUD prevalence increased from 1.9% to 2.8%, followed by a decline to 2.4% in 2022 (p-trend < 0.01). Factors that were linked with higher OUD involved patients with neoplasm-related pain(NRP)(aOR 5.718, 95% CI 5.549-5.893, p < 0.01), on palliative care (aOR 1.397, 95% CI 1.353-1.443, p < 0.001), with metastasis (aOR 1.573, 95% CI 1.526-1.621, p < 0.01), depression (aOR 1.447, 95% CI 1.400-1.495, p < 0.01), bipolar disorder (aOR 2.173, 95% CI 2.038-2.317, p < 0.01), suicidality (aOR 3.228, 95% CI 2.938-3.546, p < 0.01), and anxiety (aOR 1.617, 95% CI 1.572-1.664, p < 0.01). Moreover, substance use such as cocaine (aOR 5.252, 95% CI 4.708-5.859, p < 0.01) and amphetamine (aOR 3.948, 95% CI 3.443-4.527, p < 0.01) was also associated with higher odds, while cannabis users (aOR 0.876, 95% CI 0.793-0.968, p < 0.01) had lower odds of OUD. Our study further found racial disparities, with reduced odds among Blacks ( vs Whites, aOR 0.933, 95% CI 0.901-0.967, p < 0.01) and Hispanics (vs.Whites, aOR 0.866, 95% CI 0.827-0.906, p < 0.01). Socio-economic differences were also noted, with lower odds among those of the 26th-50th (vs. 0-25th, aOR 0.932, 95% CI 0.9-0.966, p < 0.01), 51st-75th (vs. 0-25th, aOR 0.951, 95% CI 0.918-0.986, p < 0.01), and 76th-100th (vs. 0-25th, aOR 0.916, 95% CI 0.882-0.951, p < 0.01) household income quartiles. Conclusions: This study showcases the significant prevalence and impact of OUD among BC patients, identifying socioeconomic and racial disparities, and key risk factors such as NRP, psychiatric comorbidities, and concurrent substance use, like cocaine and amphetamines. Interestingly, cannabis use was associated with a lower risk of OUD, which may reflect its role as an alternative pain management strategy. Overall, this study suggests the need to adopt crucial preventative measures against OUD in patients exhibiting these characteristics.