Nearly half of head and neck cancer surgery patients still on opioids 90 days later

A new retrospective study out of MD Anderson Cancer Center found that chronic opioid use is surprisingly common among patients treated surgically for head and neck adenoid cystic carcinoma (HNACC). Of 102 adults who underwent curative-intent surgery, nearly 44% were still on prescription opioids at postoperative day 90 — with about 56% of those reporting continuous use and the remaining 44% using opioids intermittently.

The study, published in Pain Medicine, used multivariable logistic regression to identify key risk factors. Preoperative opioid use was the biggest red flag, associated with nearly 3x greater odds of chronic postoperative opioid use. Younger patients and those with higher ASA physical status scores were also at elevated risk.

Key Takeaways:

• Preoperative opioid use was associated with ~3-fold increased odds of chronic postoperative use (OR 2.90)
• ASA Physical Status I or II was associated with 91% lower odds of chronic opioid use (OR 0.09)
• Each 10-year increase in age was associated with a 42% reduction in odds of chronic use (OR 0.58)

Why it matters: While age and health status can't be changed, identifying high-risk patients before surgery gives clinicians a window to proactively manage and potentially reduce prolonged opioid dependence in this cancer population.