Preventing Drug Addiction in Cancer Patients

Many people with cancer develop substance misuse when taking drugs to manage their pain, increasing the likelihood of complications. 

According to the American Cancer Society, substance abuse contributes to roughly 30% of cancer deaths.¹ Fortunately, drug abuse is highly preventable and treatable.

This article explores proactive strategies and interventions for preventing drug addiction in cancer patients, shedding light on the intersection of pain management, mental health, and addiction prevention in oncology care.

How Does Cancer Lead to Drug Addiction?

The emotional toll of a cancer diagnosis, treatment regimen, and uncertainty about the future can be overwhelming. These can lead to anxiety, depression, and fear, resulting in people turning to drugs or alcohol to cope with mental and emotional distress.

Drug use might initially provide a sense of escape or temporary relief from the psychological burden of the illness. However, prolonged stress, anxiety, and depression, combined with the need for pain management during treatment, can cause individuals to become dependent on these substances to alleviate their emotional and physical discomfort. 

Over time, this dependency can evolve into addiction as the body develops tolerance, ultimately resulting in a cycle that can be challenging to break.

How to Prevent Drug Addiction in Cancer Patients

Healthcare providers should regulate and monitor the use of prescription opioids in cancer patients. Typically, opioids shouldn't be prescribed for more than two weeks as it increases the risk of dependence. However, cancer patients are often exceptions to this kind of regulation due to their pain.

Cancer patients must understand the risks associated with opioid use. Healthcare professionals must also watch for signs of opioid dependence and addiction.

If you're a cancer patient or survivor, you can practice self-awareness to avoid dependence on opioids. Here are some tips to get you started:

• Keep a pain journal documenting the frequency and intensity of your pain
• Keep all your medical appointments and communicate openly with your doctors
• Let someone you love and trust oversee your intake of pain medications
• Build and maintain a reliable support system
• Enroll in peer support groups
• Enroll in therapy or counseling sessions

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Common Addiction Risks in Cancer Patients

Cancer patients are particularly susceptible to drug addiction due to prolonged exposure to potent pain medications, such as opioids, for managing severe discomfort. Additionally, the emotional strain of battling cancer can lead to heightened vulnerability, increasing the likelihood of dependency on these powerful drugs. 

1. Opioids

Cancer patients are prone to developing opioid addictions because they often take more than they’re prescribed or take them for longer than recommended.

The most common opioids prescribed to patients include:

• Hydrocodone
• Oxycodone (OxyContin)
• Hydromorphone (Dilaudid)
• Codeine
• Levorphanol (Levo-Dromoran)
• Methadone (Dolophine, Methadose)
• Morphine (Avinza, MS-Contin)
• Oxymorphone (Opana)
• Fentanyl (Actiq, Duragesic, Subsys)

When a person becomes tolerant to opioids, they increase their dose gradually, putting them at risk of developing addiction and experiencing overdose. People with opioid dependence may also experience withdrawal symptoms whenever they try to stop using.

Symptoms of opioid withdrawal include:

• Sweating
• Muscle pain
• Runny nose
• Teary eyes
• Anxiety
• Agitation
• Difficulty sleeping
• Frequent yawning
• Nausea and vomiting
• Dilated pupils
• Diarrhea
• Abdominal cramps
• Goosebumps
• Possible death

Accidental addiction to opioids is also possible and occurs with long-term opioid use or when taking opioids with alcohol.

2. Alcohol

Evidence suggests that over half of cancer survivors (56.5%) drink alcohol to cope with the stress of their diagnosis. More than 21 percent of these drinkers practiced binge drinking.³

Substance misuse complicates cancer treatments and may cause:

• Extended hospital stays
• Increased surgical procedures
• Longer recovery time
• More expensive healthcare

Excessive alcohol consumption increases mortality and morbidity rates after surgery. Drinking can cause health problems after cancer surgery due to nutritional deficiencies and poor immunity.⁷

Unlike non-drinkers, heavy drinkers are at an increased risk for cancer recurrence, advanced cancer, secondary primary tumors (metastasis), and complications of liver cancer. Alcohol abuse also contributed to a lower quality of life among patients with head and neck cancer.⁷

Dangers of Mixing Alcohol and Opiates

Alcohol, opioids, and opiates are central nervous system depressants, slowing down brain activity and some of its functions, causing relaxation. Combined, they produce dangerous mental and physical effects.

For people not yet addicted to opioids, alcohol increases their risk for addiction by amplifying the effects of opioids. Mixing these substances causes the following effects:

• Dehydration
• Loss of coordination
• Dizziness
• Extreme sleepiness
• Slurred speech or inability to talk
• Decreased blood pressure
• Irregular heart rate
• Slow and shallow breathing
• Respiratory arrest
• Snoring or gurgling sounds
• Loss of consciousness
• Bluish skin color
• Dark lips
• Coma
• Possible death

3. Tobacco Smoke

As per the American Cancer Society, tobacco smoke causes 80% of all lung cancer deaths.¹⁵ In addition, cigarettes often contain cancer-causing chemicals that can cause complications in the following conditions: 

• Esophageal cancer
• Stomach cancer
• Colon cancer
• Pancreatic cancer
• Prostate cancer
• Colorectal cancer

Even smokeless tobacco and secondhand smoke can increase cancer risk. 

4. Other Substances

People suffering from cancer-related pain may also engage in injection drug use, increasing the likelihood of developing other medical conditions like Hepatitis B and Hepatitis C. Without treatment, these complications can develop into hepatocellular carcinoma, a type of liver cancer.

Other illicit drugs that can increase a person’s risk of developing cancer-related complications include:

• Methamphetamines
• Cocaine
• MMDA

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Signs of Addiction in Cancer Patients

Knowing how to recognize signs of addiction can put you in an excellent position to help someone.

Signs of an Opioid Addiction

In many cases of opioid dependence and addiction to prescription medications, the cancer patient may not realize they have developed a dependence on the drug.

Signs of opioid addiction in these patients include:

• Taking the drug more frequently than prescribed
• Taking more than the prescribed dose
• Increased tolerance
• Running out of a prescription early
• Purchasing street drugs
• Using other drugs without their doctor’s approval
• Extreme drowsiness or sedation
• Isolating themselves
• Mood swings
• Relationship problems with friends and family
• Mental confusion

Signs of Alcohol Misuse

Although less common, patients may misuse alcohol alone or with opioids. Alcohol addiction requires immediate rehabilitation.

Here are the signs of alcohol abuse in cancer patients:

• Drinking alcohol in large amounts or for longer periods
• Difficulty reducing the amount of alcohol consumption or struggling to quit drinking
• Spending a lot of time drinking or being sick from the effects of alcohol
• Having intense cravings for alcoholic drinks
• Experiencing problems at home, school, or work as a result of drinking alcohol
• Continuing to drink alcohol even though it causes problems with friends or family
• Giving up important activities or interests to drink alcohol
• Engaging in risky behavior after heavy drinking
• Drinking, even though it causes feelings of depression, anxiety, and other health issues
• Consuming more alcohol to get the same effects previously experienced with less alcohol
• Experiencing withdrawal symptoms when the alcohol wears off

Treatment for Substance Addiction in Cancer Patients

Managing substance abuse with a concurrent cancer diagnosis is highly treatable through a multidisciplinary rehabilitation program. These programs typically involve the following aspects:

• Chronic pain management through physical therapy and acupuncture
• Behavioral therapy to manage cravings and cope with stress
• Support groups for sharing experiences
• Medical supervision and monitoring
• Addiction medicine and other necessary medical interventions
• Care coordination among various specialists
• Psychiatric support for other co-occurring mental health conditions

If you or someone you know is suffering from pain from cancer treatment and may be taking addictive substances, talk with your healthcare provider to ensure you’re taking all the right precautions.

Additional Resources:

• What Happens When You Call an Addiction Hotline?
• Dual Diagnosis Rehab
• Luxury Rehabs
• Quitting Alcohol Cold Turkey
• What Is A Halfway House?
• How to Safely Detox from Alcohol at Home
• Drug and Alcohol Rehab for Couples
• Clonidine for Opiate Withdrawal
• What is Considered an Alcoholic?
• When to Hire an Interventionist
• Alcohol Shakes (Tremors)
• How to Sober Up
• Tapering off Alcohol
• Pink Cloud Stage of Addiction Recovery

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Summary

Individuals who engage in drug abuse have an increased cancer risk. Many take opioids and illicit substances despite containing harmful toxins as a form of pain treatment. In addition, many individuals resort to drug use to manage mental health problems associated with cancer.

Mixing substances doesn’t just increase the risk of developing cancer—it also exacerbates existing cancer symptoms by attacking the immune system. By recognizing the symptoms of substance abuse, you can quickly get help and prevent your condition from worsening.

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