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Substance Abuse Among Cancer Patients
During the course of cancer treatment it is possible for patients to develop substance abuse problems. Generally patients with a history of substance abuse are much more vulnerable than patients who have not had substance abuse problems concerning drugs prescribed as part of their chemotherapy treatment regimen.
Often patients may be reluctant to disclose any past history of substance abuse to care providers because of concerns about negative attitudes or undue suspicion but disclosing past issues is paramount to successful cancer therapy.
Why Substance Abuse Can Complicate Cancer Treatment
Using illegal drugs or consuming excessive amounts of alcohol will likely interfere with treatment and further damage patient health. Psychologically, current or former substance abusers are less likely to develop strong trusting relationships with care providers and family members.
The number of substance abusers among cancer patients is not currently known. Patients with substance problems may not seek help or acknowledge to themselves or others the reality of their problems. Furthermore if the patient’s full capacity is compromised by disease progression or specific therapies, substance abuse is difficult to track.
Factors That Can Lead to Dependence
Prior History of Abuse
If a patient has a prior record of drug abuse it can be easy for them to recess to their behaviors while on cancer therapies. In order to care and monitor for at risk individuals, a strong patient-doctor relationship combined with family support, treatment for secondary psychological problems (depression, anxiety), treatment for secondary withdrawal symptoms, and constant communication are necessary for successful cancer care.
In some instances, a counselor may be appointed to monitor the patient for actions symptomatic of abuse and provide guidance, therapy, and socialization for patients.
Patients should also inform health care providers if close family members or friends are currently abusing any drug. They are more likely to provide patients with illegal substances outside of their treatment regimen.
It should be noted that cancer patients without a past history of abuse have around a 1 in 3500 chance of abusing treatment medications. Out of all patient groups, the most vulnerable is outpatients with drug histories.
Withdrawals from Treatment Medications
When an opioid (e.g. morphine) is suddenly withdrawn from treatment, abruptly reduced, or counteracted with another drug, a physical dependence may develop. Care providers often take care not to suddenly halt drug induced pain therapies for this reason and it is very uncommon for an experienced care provider to act in such a way.
For most patients as soon as pain subsides they are often able to come off medication without long term problems. As opposed to recreational use, most patients do not feel a euphoric high which limits further abuse.
A physical dependence does not constitute an addiction but patients that have overcome previous addictions may be wary of treatment fearing they may relapse or encounter strong withdrawals.
Physical Tolerance
It is possible for a patient to develop a tolerance to opioids but this is highly uncommon. The treatment length and severity required to induce a tolerance are highly improbable and no study has shown tolerance leading to addictions among cancer patients.
Insufficient Relief
If a patient’s cancer related pain is not treated properly, a patient may use drugs as a way of seeking relief. This can be easily remedied by a physician or care provider who can adjust medication as needed.
If pain is not mitigated in a timely fashion, the patient may develop
an addiction. This situation emphasizes the importance of establishing
a trusting honest relationship with your care provider