{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T01:15:34Z","timestamp":1763169334292,"version":"3.45.0"},"reference-count":63,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study examined opioid dose trajectory patterns in a cohort of disease-free cancer survivors who were at least 1\u00a0year out from completion of their cancer treatment at a single NCI-designated comprehensive cancer center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational cohort study using electronic health records. Individuals diagnosed and treated for cancer with opioid prescriptions between 2004 and 2024 were identified through a combined review of ICD-10\/ICD-9\u00a0codes. Inclusion criteria encompassed disease-free cancer patients who were prescribed opioids at least 1\u00a0year after completion of cancer treatment. Patients with cancer and sickle cell disease or receiving palliative care were excluded from the analysis. Prescriptions were standardized to average daily morphine milligram equivalent (MME) for a period of 24\u00a0months. Participants were classified as high-dose (\u2265\u200950 MME\/day) or low-dose (&lt;\u200950 MME\/day) persisters based on the strength of their average daily MMEs 1\u00a0year after completion of their cancer treatment. Prescription patterns were elicited using group-based trajectory modeling, and linear mixed-effects regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1688 disease-free cancer survivors were identified, with 610 being prescribed opioids 1\u00a0year after completion of their cancer treatment. Low-dose persisters (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009404) exhibited two trajectories: discontinuers (61.7%) and escalators (38.3%). Low-dose escalators increased from\u2009&lt;\u200950 MMEs\/day to an average of 100 MMEs\/day at 24\u00a0months. High-dose persisters, i.e., individuals on\u2009\u2265\u200950 MMEs\/day (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009206) at 1\u00a0year after completion of their cancer treatment, exhibited escalating doses up to 250 MMEs at 24\u00a0months. Sex and race were the only sociodemographic characteristics found to be significant predictors of continued opioid exposure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In our cohort of 610 disease-free cancer survivors on opioids at least 1\u00a0year after completion of their cancer treatment, 59.2% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009361) were prescribed escalating doses of opioids. Since higher opioid doses have been shown to be associated with increased risks of harm, future multicenter studies are needed to examine the factors associated with increasing opioid doses as well as intervention strategies to mitigate opioid escalation in disease-free cancer survivors.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-025-10003-z","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T10:41:20Z","timestamp":1762166480000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Opioid prescription patterns in long-term disease-free cancer survivors: a retrospective analysis at a single NCI-designated comprehensive cancer center"],"prefix":"10.1007","volume":"33","author":[{"given":"Vasco M.","family":"Pontinha","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livingstone","family":"Aduse-Poku","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard F.","family":"Moeller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato G.","family":"Martins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Noreika","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"issue":"4","key":"10003_CR1","first-page":"308","volume":"75","author":"NS Wagle","year":"2025","unstructured":"Wagle NS et al (2025) Cancer treatment and survivorship statistics, 2025. CA Cancer J Clin 75(4):308\u2013340","journal-title":"CA Cancer J Clin"},{"issue":"8","key":"10003_CR2","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1001\/jamaoncol.2019.1439","volume":"5","author":"C Jiang","year":"2019","unstructured":"Jiang C et al (2019) Prevalence of chronic pain and high-impact chronic pain in cancer survivors in the United States. JAMA Oncol 5(8):1224\u20131226","journal-title":"JAMA Oncol"},{"issue":"16","key":"10003_CR3","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1200\/JCO.2013.52.4629","volume":"32","author":"PA Glare","year":"2014","unstructured":"Glare PA et al (2014) Pain in cancer survivors. J Clin Oncol 32(16):1739\u20131747","journal-title":"J Clin Oncol"},{"issue":"7","key":"10003_CR4","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1093\/jnci\/djz200","volume":"112","author":"LK Vitzthum","year":"2020","unstructured":"Vitzthum LK et al (2020) Predicting persistent opioid use, abuse, and toxicity among cancer survivors. J Natl Cancer Inst 112(7):720\u2013727","journal-title":"J Natl Cancer Inst"},{"issue":"3","key":"10003_CR5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7103a1","volume":"71","author":"D Dowell","year":"2022","unstructured":"Dowell D (2022) CDC clinical practice guideline for prescribing opioids for pain - United States, 2022. MMWR Recomm Rep 71(3):1\u201395","journal-title":"MMWR Recomm Rep"},{"issue":"4","key":"10003_CR6","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1200\/JCO.22.02198","volume":"41","author":"JA Paice","year":"2023","unstructured":"Paice JA (2023) Use of opioids for adults with pain from cancer or cancer treatment: ASCO guideline. J Clin Oncol 41(4):914\u2013930","journal-title":"J Clin Oncol"},{"issue":"7s","key":"10003_CR7","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.36076\/ppj.2023.26.S7","volume":"26","author":"L Manchikanti","year":"2023","unstructured":"Manchikanti L (2023) Comprehensive, evidence-based, consensus guidelines for prescription of opioids for chronic non-cancer pain from the American Society of Interventional Pain Physicians (ASIPP). Pain Physician 26(7s):S7-s126","journal-title":"Pain Physician"},{"key":"10003_CR8","doi-asserted-by":"crossref","unstructured":"Nabulsi NA et al (2023) Patterns of prescription opioid use and opioid-related harms among adult patients with hematologic malignancies. J Oncol Pharm Pract 10781552231210788","DOI":"10.1177\/10781552231210788"},{"issue":"5","key":"10003_CR9","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1111\/anae.14207","volume":"73","author":"A Eochagain","year":"2018","unstructured":"Eochagain A et al (2018) The effect of anaesthetic technique during primary breast cancer surgery on neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and return to intended oncological therapy. Anaesthesia 73(5):603\u2013611","journal-title":"Anaesthesia"},{"issue":"2","key":"10003_CR10","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/0889-1591(89)90013-5","volume":"3","author":"B Beilin","year":"1989","unstructured":"Beilin B (1989) Suppression of natural killer cell activity by high-dose narcotic anesthesia in rats. Brain Behav Immun 3(2):129\u2013137","journal-title":"Brain Behav Immun"},{"issue":"14","key":"10003_CR11","doi-asserted-by":"crossref","first-page":"2726","DOI":"10.1111\/bph.13903","volume":"175","author":"JW Boland","year":"2018","unstructured":"Boland JW, Pockley AG (2018) Influence of opioids on immune function in patients with cancer pain: from bench to bedside. Br J Pharmacol 175(14):2726\u20132736","journal-title":"Br J Pharmacol"},{"issue":"3","key":"10003_CR12","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/s00441-016-2461-3","volume":"365","author":"IA Darby","year":"2016","unstructured":"Darby IA, Hewitson TD (2016) Hypoxia in tissue repair and fibrosis. Cell Tissue Res 365(3):553\u2013562","journal-title":"Cell Tissue Res"},{"key":"10003_CR13","volume":"83","author":"M Ma","year":"2020","unstructured":"Ma M (2020) Low-dose naltrexone inhibits colorectal cancer progression and promotes apoptosis by increasing M1-type macrophages and activating the Bax\/Bcl-2\/caspase-3\/PARP pathway. Int Immunopharmacol 83:106388","journal-title":"Int Immunopharmacol"},{"issue":"8","key":"10003_CR14","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1002\/hed.27432","volume":"45","author":"SM Nugent","year":"2023","unstructured":"Nugent SM et al (2023) Prevalence and correlates of high-dose opioid use among survivors of head and neck cancer. Head Neck 45(8):2058\u20132067","journal-title":"Head Neck"},{"issue":"12","key":"10003_CR15","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1016\/j.trecan.2016.10.016","volume":"2","author":"L Schito","year":"2016","unstructured":"Schito L, Semenza GL (2016) Hypoxia-inducible factors: master regulators of cancer progression. Trends Cancer 2(12):758\u2013770","journal-title":"Trends Cancer"},{"issue":"4","key":"10003_CR16","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1159\/000078444","volume":"11","author":"Y Shavit","year":"2004","unstructured":"Shavit Y (2004) Effects of fentanyl on natural killer cell activity and on resistance to tumor metastasis in rats. Neuroimmunomodulation 11(4):255\u2013260","journal-title":"Neuroimmunomodulation"},{"issue":"2","key":"10003_CR17","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1093\/abbs\/gmx131","volume":"50","author":"Q Wu","year":"2018","unstructured":"Wu Q (2018) Nalmefene attenuates malignant potential in colorectal cancer cell via inhibition of opioid receptor. Acta Biochim Biophys Sin 50(2):156\u2013163","journal-title":"Acta Biochim Biophys Sin"},{"issue":"1","key":"10003_CR18","volume":"18","author":"T Yan","year":"2018","unstructured":"Yan T et al (2018) Effects of propofol\/remifentanil-based total intravenous anesthesia versus sevoflurane-based inhalational anesthesia on the release of VEGF-C and TGF-\u03b2 and prognosis after breast cancer surgery: a prospective, randomized and controlled study. BMC Anesthesiol 18(1):131","journal-title":"BMC Anesthesiol"},{"issue":"12","key":"10003_CR19","first-page":"9781","volume":"30","author":"DK Check","year":"2022","unstructured":"Check DK (2022) Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis. Support Care Cancer 30(12):9781\u20139791","journal-title":"Support Care Cancer"},{"issue":"4","key":"10003_CR20","first-page":"391","volume":"110","author":"SS Coughlin","year":"2018","unstructured":"Coughlin SS (2018) Advancing uterine cancer survivorship among African American women. J Natl Med Assoc 110(4):391\u2013395","journal-title":"J Natl Med Assoc"},{"issue":"3","key":"10003_CR21","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1177\/0194599818778276","volume":"160","author":"A Saraswathula","year":"2019","unstructured":"Saraswathula A et al (2019) Persistent postoperative opioid use in older head and neck cancer patients. Otolaryngol Head Neck Surg 160(3):380\u2013387","journal-title":"Otolaryngol Head Neck Surg"},{"key":"10003_CR22","doi-asserted-by":"publisher","DOI":"10.1093\/oncolo\/oyae270","author":"R Haque","year":"2025","unstructured":"Haque R et al (2025) Opioid use and adverse health effects in breast cancer survivors. Oncologist. https:\/\/doi.org\/10.1093\/oncolo\/oyae270","journal-title":"Oncologist"},{"issue":"5.5","key":"10003_CR23","first-page":"595","volume":"17","author":"JA Paice","year":"2019","unstructured":"Paice JA (2019) Managing pain in patients and survivors: challenges within the United States opioid crisis. J Natl Compr Canc Netw 17(5.5):595\u2013598","journal-title":"J Natl Compr Canc Netw"},{"key":"10003_CR24","doi-asserted-by":"crossref","first-page":"107327482412907","DOI":"10.1177\/10732748241290769","volume":"31","author":"R Safarudin","year":"2024","unstructured":"Safarudin R et al (2024) Prescription opioid use before and after diagnosis of cancer among older cancer survivors with non-cancer chronic pain conditions (NCPCs): an application of group-based trajectory modeling (GBTM). Cancer Control 31:10732748241290768","journal-title":"Cancer Control"},{"issue":"9","key":"10003_CR25","volume":"3","author":"AN Winn","year":"2020","unstructured":"Winn AN et al (2020) Association of current opioid use with serious adverse events among older adult survivors of breast cancer. JAMA Netw Open 3(9):e2016858","journal-title":"JAMA Netw Open"},{"issue":"7","key":"10003_CR26","doi-asserted-by":"crossref","first-page":"6838","DOI":"10.3390\/curroncol30070500","volume":"30","author":"F Mestdagh","year":"2023","unstructured":"Mestdagh F, Steyaert A, Lavand\u2019homme P (2023) Cancer pain management: a narrative review of current concepts, strategies, and techniques. Curr Oncol 30(7):6838\u20136858","journal-title":"Curr Oncol"},{"issue":"1","key":"10003_CR27","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jpainsymman.2019.02.024","volume":"58","author":"L Barbera","year":"2019","unstructured":"Barbera L (2019) Factors associated with opioid use in long-term cancer survivors. J Pain Symptom Manage 58(1):100-107.e2","journal-title":"J Pain Symptom Manage"},{"issue":"5","key":"10003_CR28","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1111\/jgs.15945","volume":"67","author":"R Shah","year":"2019","unstructured":"Shah R (2019) Long-term opioid therapy in older cancer survivors: a retrospective cohort study. J Am Geriatr Soc 67(5):945\u2013952","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"10003_CR29","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/s10549-023-07205-6","volume":"204","author":"CY Chang","year":"2024","unstructured":"Chang CY et al (2024) Association between trajectories of prescription opioid use and risk of opioid use disorder and overdose among US nonmetastatic breast cancer survivors. Breast Cancer Res Treat 204(3):561\u2013577","journal-title":"Breast Cancer Res Treat"},{"key":"10003_CR30","doi-asserted-by":"publisher","DOI":"10.1177\/10732748241290769","author":"R Safarudin","year":"2024","unstructured":"Safarudin R et al (2024) Prescription opioid use before and after diagnosis of cancer among older cancer survivors with non-cancer chronic pain conditions (NCPCs): an application of group-based trajectory modeling (GBTM). Cancer Control. https:\/\/doi.org\/10.1177\/10732748241290769","journal-title":"Cancer Control"},{"key":"10003_CR31","unstructured":"Robert Graham Center - Policy Studies in Family Medicine & Primary Care (2019) Social deprivation index (SDI). Available from: https:\/\/www.graham-center.org\/rgc\/maps-data-tools\/sdi\/social-deprivation-index.html."},{"issue":"11","key":"10003_CR32","doi-asserted-by":"crossref","first-page":"e2344546","DOI":"10.1001\/jamanetworkopen.2023.44546","volume":"6","author":"TV Newman","year":"2023","unstructured":"Newman TV et al (2023) Use of disease-modifying treatments in patients with sickle cell disease. JAMA Netw Open 6(11):e2344546\u2013e2344546","journal-title":"JAMA Netw Open"},{"issue":"10","key":"10003_CR33","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpain.2024.104603","volume":"25","author":"I Belfer","year":"2024","unstructured":"Belfer I et al (2024) Unmet need: mechanistic and translational studies of sickle cell disease pain as a whole-person health challenge. J Pain 25(10):104603","journal-title":"J Pain"},{"key":"10003_CR34","unstructured":"National Center for Injury Prevention and Control (2017) CDC compilation of benzodiazepines, muscle relaxants, stimulants, zolpidem, and opioid analgesics with oral morphine milligram equivalent conversion factors, 2017 version. Available from: https:\/\/www.cdc.gov\/drugoverdose\/resources\/data.html."},{"issue":"7","key":"10003_CR35","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1177\/0962280216673085","volume":"27","author":"DS Nagin","year":"2018","unstructured":"Nagin DS et al (2018) Group-based multi-trajectory modeling. Stat Methods Med Res 27(7):2015\u20132023","journal-title":"Stat Methods Med Res"},{"key":"10003_CR36","doi-asserted-by":"crossref","unstructured":"Nagin DS (2005) Group-based modeling of development. Harvard University Press","DOI":"10.4159\/9780674041318"},{"issue":"2\u20133","key":"10003_CR37","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1159\/000360229","volume":"65","author":"DS Nagin","year":"2014","unstructured":"Nagin DS (2014) Group-based trajectory modeling: an overview. Ann Nutr Metab 65(2\u20133):205\u2013210","journal-title":"Ann Nutr Metab"},{"issue":"1","key":"10003_CR38","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1146\/annurev-statistics-022513-115701","volume":"1","author":"EA Erosheva","year":"2014","unstructured":"Erosheva EA, Matsueda RL, Telesca D (2014) Breaking bad: two decades of life-course data analysis in criminology, developmental psychology, and beyond. Annu Rev Stat Appl 1(1):301\u2013332","journal-title":"Annu Rev Stat Appl"},{"issue":"2","key":"10003_CR39","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1177\/0049124106292292","volume":"35","author":"T Loughran","year":"2006","unstructured":"Loughran T, Nagin DS (2006) Finite sample effects in group-based trajectory models. Sociol Methods Res 35(2):250\u2013278","journal-title":"Sociol Methods Res"},{"issue":"20","key":"10003_CR40","doi-asserted-by":"crossref","first-page":"2349","DOI":"10.1002\/(SICI)1097-0258(19971030)16:20<2349::AID-SIM667>3.0.CO;2-E","volume":"16","author":"A Cnaan","year":"1997","unstructured":"Cnaan A, Laird NM, Slasor P (1997) Using the general linear mixed model to analyse unbalanced repeated measures and longitudinal data. Stat Med 16(20):2349\u20132380","journal-title":"Stat Med"},{"key":"10003_CR41","unstructured":"Diggle P et al (2013) Analysis of longitudinal data. 2nd ed. Oxford University Press"},{"issue":"4","key":"10003_CR42","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1177\/0049124113503141","volume":"42","author":"BL Jones","year":"2013","unstructured":"Jones BL, Nagin DS (2013) A note on a Stata plugin for estimating group-based trajectory models. Sociol Methods Res 42(4):608\u2013613","journal-title":"Sociol Methods Res"},{"key":"10003_CR43","unstructured":"StataCorp (2019) Stata statistical software: release 16. StataCorp, LLC: College Station, TX"},{"key":"10003_CR44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2024.06.006","author":"B Daniels","year":"2024","unstructured":"Daniels B (2024) Trajectories of opioid use before and after cancer diagnosis: a population-based cohort study. J Pain Symptom Manage. https:\/\/doi.org\/10.1016\/j.jpainsymman.2024.06.006","journal-title":"J Pain Symptom Manage"},{"issue":"15","key":"10003_CR45","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1001\/jama.2016.1464","volume":"315","author":"D Dowell","year":"2016","unstructured":"Dowell D, Haegerich TM, Chou R (2016) CDC guideline for prescribing opioids for chronic pain\u2013United States, 2016. JAMA 315(15):1624\u20131645","journal-title":"JAMA"},{"key":"10003_CR46","doi-asserted-by":"crossref","unstructured":"Chou R et al (2020) In Opioid treatments for chronic pain. Rockville (MD)","DOI":"10.23970\/AHRQEPCCER229"},{"issue":"4","key":"10003_CR47","doi-asserted-by":"crossref","first-page":"276","DOI":"10.7326\/M14-2559","volume":"162","author":"R Chou","year":"2015","unstructured":"Chou R et al (2015) The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health pathways to prevention workshop. Ann Intern Med 162(4):276\u2013286","journal-title":"Ann Intern Med"},{"issue":"3","key":"10003_CR48","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.cnur.2021.04.003","volume":"56","author":"JM Delle","year":"2021","unstructured":"Delle JM, Gazley C (2021) Advocating for multimodal pain management and reducing the need for opioids in the acute and chronic pain setting. Nurs Clin North Am 56(3):357\u2013367","journal-title":"Nurs Clin North Am"},{"issue":"2","key":"10003_CR49","doi-asserted-by":"crossref","first-page":"637","DOI":"10.21037\/tcr-20-2692","volume":"10","author":"H Bao","year":"2021","unstructured":"Bao H et al (2021) The efficacy of gabapentin combined with opioids for neuropathic cancer pain: a meta-analysis. Transl Cancer Res 10(2):637\u2013644","journal-title":"Transl Cancer Res"},{"issue":"36","key":"10003_CR50","doi-asserted-by":"crossref","first-page":"4042","DOI":"10.1200\/JCO.2017.74.1363","volume":"35","author":"JS Lee","year":"2017","unstructured":"Lee JS et al (2017) New persistent opioid use among patients with cancer after curative-intent surgery. J Clin Oncol 35(36):4042\u20134049","journal-title":"J Clin Oncol"},{"issue":"10","key":"10003_CR51","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1007\/s40263-019-00660-0","volume":"33","author":"S Mercadante","year":"2019","unstructured":"Mercadante S, Arcuri E, Santoni A (2019) Opioid-induced tolerance and hyperalgesia. CNS Drugs 33(10):943\u2013955","journal-title":"CNS Drugs"},{"issue":"3","key":"10003_CR52","doi-asserted-by":"crossref","first-page":"679","DOI":"10.36076\/ppj.2009\/12\/679","volume":"12","author":"SM Silverman","year":"2009","unstructured":"Silverman SM (2009) Opioid induced hyperalgesia: clinical implications for the pain practitioner. Pain Physician 12(3):679\u2013684","journal-title":"Pain Physician"},{"issue":"13","key":"10003_CR53","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1056\/NEJMra1507771","volume":"374","author":"ND Volkow","year":"2016","unstructured":"Volkow ND, McLellan AT (2016) Opioid abuse in chronic pain\u2013misconceptions and mitigation strategies. N Engl J Med 374(13):1253\u20131263","journal-title":"N Engl J Med"},{"issue":"4","key":"10003_CR54","doi-asserted-by":"crossref","first-page":"349","DOI":"10.5055\/jom.0891","volume":"21","author":"S Sochacki","year":"2025","unstructured":"Sochacki S (2025) Hyperalgesia, allodynia, and eventual overdose: the problems with chronic opioid use. J Opioid Manag 21(4):349\u2013353","journal-title":"J Opioid Manag"},{"issue":"9","key":"10003_CR55","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.6004\/jnccn.2010.0079","volume":"8","author":"N Moryl","year":"2010","unstructured":"Moryl N (2010) Chronic pain management in cancer survivors. J Natl Compr Canc Netw 8(9):1104\u20131110","journal-title":"J Natl Compr Canc Netw"},{"key":"10003_CR56","doi-asserted-by":"publisher","DOI":"10.7573\/dic.2022-11-7","author":"G Porzio","year":"2023","unstructured":"Porzio G (2023) Multidisciplinary approach, continuous care and opioid management in cancer pain: case series and review of the literature. Drugs Context. https:\/\/doi.org\/10.7573\/dic.2022-11-7","journal-title":"Drugs Context"},{"issue":"8","key":"10003_CR57","doi-asserted-by":"crossref","first-page":"977","DOI":"10.6004\/jnccn.2019.0038","volume":"17","author":"RA Swarm","year":"2019","unstructured":"Swarm RA (2019) Adult cancer pain, version 3.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 17(8):977\u20131007","journal-title":"J Natl Compr Canc Netw"},{"issue":"5","key":"10003_CR58","first-page":"409","volume":"72","author":"KD Miller","year":"2022","unstructured":"Miller KD et al (2022) Cancer treatment and survivorship statistics, 2022. CA Cancer J Clin 72(5):409\u2013436","journal-title":"CA Cancer J Clin"},{"issue":"4","key":"10003_CR59","doi-asserted-by":"crossref","first-page":"e397","DOI":"10.1016\/j.jpainsymman.2021.10.015","volume":"63","author":"DK Check","year":"2022","unstructured":"Check DK (2022) Opioid prescribing and use among cancer survivors: a mapping review of observational and intervention studies. J Pain Symptom Manage 63(4):e397\u2013e417","journal-title":"J Pain Symptom Manage"},{"issue":"8","key":"10003_CR60","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.13605","volume":"3","author":"V Jairam","year":"2020","unstructured":"Jairam V et al (2020) National patterns in prescription opioid use and misuse among cancer survivors in the United States. JAMA Netw Open 3(8):e2013605","journal-title":"JAMA Netw Open"},{"key":"10003_CR61","doi-asserted-by":"crossref","DOI":"10.1016\/j.drugalcdep.2023.110950","volume":"251","author":"MN Poulsen","year":"2023","unstructured":"Poulsen MN (2023) Identification of opioid use disorder using electronic health records: beyond diagnostic codes. Drug Alcohol Depend 251:110950","journal-title":"Drug Alcohol Depend"},{"issue":"4 Suppl","key":"10003_CR62","doi-asserted-by":"crossref","first-page":"S99","DOI":"10.1097\/00002508-200207001-00012","volume":"18","author":"MJ Cohen","year":"2002","unstructured":"Cohen MJ et al (2002) Ethical perspectives: opioid treatment of chronic pain in the context of addiction. Clin J Pain 18(4 Suppl):S99-107","journal-title":"Clin J Pain"},{"key":"10003_CR63","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jsat.2020.02.001","volume":"112S","author":"DM Boudreau","year":"2020","unstructured":"Boudreau DM et al (2020) Documented opioid use disorder and its treatment in primary care patients across six U.S. health systems. J Subst Abuse Treat 112S:41\u201348","journal-title":"J Subst Abuse Treat"}],"container-title":["Supportive Care in Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-025-10003-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-025-10003-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-025-10003-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T01:12:28Z","timestamp":1763169148000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00520-025-10003-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":63,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10003"],"URL":"https:\/\/doi.org\/10.1007\/s00520-025-10003-z","relation":{},"ISSN":["0941-4355","1433-7339"],"issn-type":[{"type":"print","value":"0941-4355"},{"type":"electronic","value":"1433-7339"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"In compliance with the Declaration of Helsinki, this research project underwent appropriate IRB approval (HM20029100) from the Virginia Commonwealth University. Patient data management complied with the HIPAA requirements.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1011"}}