Prevalence of abnormal urine drug tests during COVID-19 pandemic in the cancer patient population: retrospective study

Abstract

Background: Opioid misuse is a persistent concern, heightened by the COVID-19 pandemic. This study examines the risk factors contributing to elevated rates of abnormal urine drug tests (UDTs) in the cancer pain patient population during COVID-19. Materials & methods: A retrospective chart review of 500 patient encounters involving UDTs at a comprehensive cancer center. Results: Medication adherence rates increase when UDTs are incorporated into a chronic cancer pain management protocol. Higher positive tests for illicit or nonprescribed substances in patients with specific risk factors: current smokers (tobacco), no active cancer and concurrent benzodiazepine use. Conclusion: This research emphasizes the increased risk of opioid misuse during COVID-19 among cancer pain patients with specific risk factors outlined in the results.

Plain language summary

This study looked at how the COVID-19 pandemic has affected opioid use among people with cancer-related pain. The researchers checked the records of 500 patients who had had tests to see if they used opioids correctly. They found that when these tests were part of the treatment plan, patients were more likely to take their medicines correctly. However, they also noticed that certain patients, such as those who smoke, do not have active cancer or are taking another type of medication (i.e., benzodiazepines), are more likely to use opioids or other drugs in ways that deviated from the original intention. This study shows that during the pandemic, which continues to exist, it is even more important to watch how these patients use their painkillers and help them avoid misuse.

Tweetable abstract

This study analyzed urine drug tests in cancer pain patients during COVID-19. Findings revealed higher positive tests for illicit or nonprescribed substances in patients with specific risk factors: current smokers (tobacco), no active cancer and concurrent benzodiazepine use.

@MDAndersonNews; @VbansalMD; @DrlocplamDO; #CancerPain, #Opioids, #OpioidAbuse, #ChronicPain, #Covid-19, #UrineDrugTesting #UDT

Keywords: :

• cancer pain
• COVID-19
• COVID-19 pandemic
• opioid crisis
• psychosocial factors
• urine drug testing

Author contributions

V Bansal – contributions meet authorship criteria (a), (b), (c) and (d) as outlined in the Author Disclosure Form; L Lam – contributions meet authorship criteria (a), (b), (c) and (d) as outlined in the Author Disclosure Form; AV Brown – contributions meet authorship criteria (a), (b), (c) and (d) as outlined in the Author Disclosure Form; S Javed – contributions meet authorship criteria (a), (b), (c) and (d) as outlined in the Author Disclosure Form. Authorship criteria outline in the author disclosure form is briefly defined as (a) substantial contributions to the manuscript (i.e., design, data acquisition, analysis, interpretation); AND (b) drafts and revisions for pertinent information; AND (c) final approval of the version to be published; AND (d) agreement to be accountable for all aspects of the work and appropriate investigation into further questions.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval for this study protocol. Since this was a retrospectives chart review, a waiver of consent (a waiver of authorization) was obtained due to the retrospective nature of this review, involving no diagnostic or therapeutic intervention and no direct contact with the patients. Obtaining consent from these patients would have been impracticable, as they are lost to follow-up, no longer in treatment or deceased.