Prolonged opioid use after lung cancer surgery is associated with 40% increased risk of death

Prolonged use of opioids to relieve pain after lung cancer surgery is associated with a 40% increased risk of death from any cause over the next 2 years, a study published in Regional Anesthesia & Pain Medicine found.

Lung cancer is the leading cause of cancer death worldwide, with about 2.3 million diagnoses and 1.8 million deaths in 2020. New persistent postoperative pain is reported in 12% of patients.

The study included all adults diagnosed with lung cancer and who underwent surgery for the disease between 2011 and 2018 in South Korea, information from the National Health Insurance Service database.

Codeine, dihydrocodeine, and tramadol were classified as less strong opioids; all other opioids, such as fentanyl, morphine, oxycodone, hydromorphone, and methadone, were classified as strong opioids.

During the study period, 60,031 adults underwent lung cancer surgery, and after excluding those who died in the hospital or within the first 6 months of discharge, 54,509 of them were included in the final analysis.

Six months after surgery, 3,325 patients (just over 6%) who had recently been prescribed opioids were still taking them: 859 (1.6%) were taking potent drugs and 2,466 (4.5%) were taking less potent drugs.

New long-term opioid use was associated with an increased risk of death from any cause over the next 2 years; 17.5% of long-term opioid users died compared with 9.5% of nonopioid users.

Compared with non-opioid users, new long-term opioid users were 40% more likely to die in the next 2 years from any cause.

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