Alcohol, Tobacco, and Substance Use and Association with Opioid Use Disorder in Patients with Non-malignant and Cancer Pain: a Review

Abstract

The following review will highlight recent studies reporting associations between alcohol and tobacco use with non-medical opioid use in the post-operative period, as well as patients with chronic non-malignant and cancer pain. The use of alcohol, tobacco, and other illegal substances are associated with an increased risk of opioid use disorder in the post-operative setting and in patients with chronic non-malignant and cancer pain. Opioid overdoses are at a national epidemic afflicting the general population. A comprehensive assessment of the risk for opioid use disorder is advocated prior to the prescription of opioids and includes obtaining a family and personal history of any substance use including alcohol and tobacco, as well as any psychiatric mood disorders. Strategies to manage pain in patients with high risk for opioid use disorders include decreased intervals between clinic visits, increase frequency of compliance monitoring with urine drug screens, and psychosocial support.