Outcomes of Discontinuing Long-Term Opioid Therapy among Older Cancer Survivors in Long-Term Care Settings.

The study was observational, not a trial of stopping opioids, so it cannot prove that discontinuation caused better pain, lower opioid use disorder, or lower overdose rates. Residents who discontinued may have differed in ways not measured, such as why opioids were stopped, who decided to stop them, or whether discontinuation was clinically appropriate. Unmeasured factors such as loss of a prescriber could explain early pain-related hospitalizations and emergency visits. Medicare prescription data did not capture self-paid prescriptions or opioids covered by other programs, so some discontinuations or continued use may have been misclassified. Long hospital stays of 90 days or more were excluded, so residents with long hospitalizations were not studied. Residents with severe cognitive impairment or lost ability to communicate were excluded, so findings do not apply to nursing home residents with severe cognitive impairment. Findings apply only to older long-term care cancer survivors with chronic pain, no active cancer treatment, no palliative or hospice care, and life expectancy not documented as less than 6 months. Pain-related hospitalizations and emergency visits were higher in crude early quarters among discontinuers, while adjusted 1-year rates were not different.

The authors declare no conflicts of interest. The article is tagged as supported by NIH extramural and non-U.S. government research support.

Do not read this as proof that stopping long-term opioids improves pain or prevents overdose. It compared residents who already stopped with those who continued, without data on why they stopped, and pain-related hospitalizations and emergency visits were higher in early quarters.