Opioid Use in Managing Pain in Myeloma | Karen Sweiss, PharmD | ASH 2022

Good morning. My name is Karen Swise. I am a PharmD, a clinical investigator at the University of Illinois at Chicago. And I'm happy to talk to you today about some of the research that we have been presenting, especially here at ASH. We have been talking about a topic that I think is very important to myeloma patients, and it's about pain. Our abstract was presented on Saturday. We looked at specifically the use of opioid medications, which these medications include drugs like morphine, Dilaudid, medications that are often prescribed for patients with myeloma who have pain. And so we were very interested in the topic about how are opioids prescribed and in patients who achieve a more long-term remission, does opioid use persist? And then we specifically wanted to look at how does long-term opioid use correlate with outcomes? And so we had some interesting findings. What we observed is that there was a high prevalence of opioid use at baseline in patients with myeloma. It was about 50% of patients. And interestingly, it was independent of whether or not patients had bony disease. So we went on to look at opioid use over time throughout the disease trajectory, specifically when they're in the hospital for transplant and then after transplant. And we noticed that once they were hospitalized, 80% of patients were put on opioids. And then when they left the hospital, we found that there was 40% new opioid users. And when we look at the use of opioids at six months, it's a significant predictor of overall survival. And so this is really important work because although it's a retrospective study, it's one of the first insights into the patterns of use in myeloma patients, but also what's the next step? And so we wanted to further delineate what are patients' attitudes towards taking opioids and what is their experience in terms of the interaction with their provider? Are there fears? Are there certain attitudes that prevent or enable patients being on opioids long term, maybe not necessarily needing them for that long? And so it'll be a good segue because we're working with investigators, specifically at Emory, Dr. Craig Hofmeister. In collaboration with him and Health Tree, we'll be administering a survey soon through the Health Tree organization, which will, what we're trying to do is address questions related to opioid use among myeloma patients. And so the survey will encompass questions about patient perceptions, about opioids, patient perceptions, about pain, really trying to understand the reasons patients are taking opioids for long term. And then we're also going to explore a topic that I think in experience has come up very often lately, especially in the last year is cannabis use. I think now in many states it's legalized. And so the use of cannabis for medicinal purposes has really increased in cancer patients. And I think we just don't have any data in myeloma to really understand what would patients use cannabis for, what are their perceptions towards using cannabis, what barriers exist to getting cannabis. And so this will be an interesting survey to really provide insight on these high risk opioid medications, but also the potential use of cannabis for pain.