Mental Health Consequences of Opioid Pain Medication Use Behaviors and Motives Among Adolescents and Young Adults With Cancer: Results From a National Survey.

Background: Adolescents and young adults (AYA) with cancer experience long-term consequences into survivorship that impact quality of life, including mental health symptoms, substance use, and persistent pain. Given the elevated rates of pain, AYA cancer survivors are at increased risk for opioid pain medication (OPM) exposure, increasing risk for opioid-related negative consequences, particularly for those with mental health symptoms. Minimal research has documented that a considerable proportion of AYAs with cancer receive OPM that continues into survivorship, yet the lack of consensus on the definition of problematic opioid use coupled with the high clinical need for OPM makes it particularly challenging to understand the impact of OPM use in this population.

Aims: Therefore, the current study examined differences in opioid pain medication use, use behaviors, and motives between AYA cancer survivors and non-cancer controls.

Methods: Using the National Survey on Drug Use and Health, we tested the impact of OPM use behaviors and motives on depressive symptoms and mental healthcare utilization variables.

Results: Results show that, compared to non-cancer controls, AYA cancer survivors evince higher rates of opioid use, behaviors, and pain relief motives. Within the cancer survivor group only, there were differential patterns of associations between OPM behaviors, motives, depressive symptoms, and mental healthcare utilization, with using opioid pain medication for emotion coping/to get high showed the largest effect sizes with outcome variables.

Conclusions: The results highlight the importance of moving beyond use itself and examining how and why AYAs with cancer are using opioids to understand potential negative consequences.