{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T21:12:48Z","timestamp":1767906768110,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,6,4]],"date-time":"2017-06-04T00:00:00Z","timestamp":1496534400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:p>In the context of a therapeutic opioid epidemic, particularly in the USA, where increasingly stringent screening for \u2018at risk\u2019 individuals and close monitoring of opioid prescription and use is strongly recommended, the issue of misuse within the cancer population must be addressed. Most patients with advanced cancer will have pain requiring opioid therapy at some stage during their disease course. In the majority, this will provide good pain relief with no short\u2010 or longer\u2010term adverse sequelae. A subset will present with substance misuse issues that will influence management and prescribing practice. The potential ethical issues of limiting effective analgesia on the basis of addiction risk or history must be acknowledged. Both a judgemental or \u2018relaxed\u2019 approach to such patients is problematic. Ignoring the situation will not be in the patient's best interest, but an undue focus on this aspect may damage therapeutic relationships with clinicians and adversely affect a holistic approach to care. Clinical practitioners must be aware of the risk factors for opioid misuse and in patients who are not under palliative care consider screening prior to commencing opioids. Clinicians must be able to manage and monitor those identified as having an opioid misuse problem.<\/jats:p>","DOI":"10.1111\/imj.13449","type":"journal-article","created":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T04:30:15Z","timestamp":1496637015000},"page":"632-636","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Opioid addiction and misuse in adult and adolescent patients with cancer"],"prefix":"10.1111","volume":"47","author":[{"given":"Ross","family":"Pinkerton","sequence":"first","affiliation":[{"name":"Hummingbird House Children's Hospice  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1127-9951","authenticated-orcid":false,"given":"Janet R.","family":"Hardy","sequence":"additional","affiliation":[{"name":"Palliative and Supportive Care Services Mater Cancer Care Centre  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-007-0204-6"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.56.0383"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-010-0118-6"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/med\/9780199656097.003.0094"},{"key":"e_1_2_8_6_1","unstructured":"BelisomoR.Fears of addiction keep cancer patients from getting pain relief.Reuters Health News2014Aug 29 [cited May 2017]. 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