Opioid Abuse and Dependence in Those Hospitalized Due to Head and Neck Cancers

Objectives: Objective of the present study is to identify factors associated with opioid abuse/dependence (OAD) in those hospitalized due to head and neck cancers (HNC) in the USA.
Methods: Nationwide Inpatient Sample for years 2012 to 2014 was used. All patients hospitalized due to any HNC were selected. OAD prevalence was identified. Patient demographics, hospital, and geographic factors were independent variables while OAD was outcome. Multivariable logistic regression model was used to identify factors associated with OAD. Effects of clustering of outcomes within hospitals and HNC types were adjusted.
Results: 92,055 patients were hospitalized due to HNCs. Mean age was 62 years. OAD was prevalent in 0.8% and OAD rates were highest in patients with malignant neoplasm of ill-defined sites within lip, oral cavity, and pharynx (1.6%) followed by patients with malignant neoplasms of larynx (1.4%), and malignant neoplasm of hypopharynx (1.3%). Patients aged 30-44 years (OR=5.19, 95%CI=2.23-12.06, p<0.01) and 45-64 years (OR=4.05, 95%CI=2.15-7.61, p<0.01) were associated with higher odds for OAD compared to those aged>64 years. Blacks (OR=1.76, 95%CI=1.12-2.78, p=0.01) and Hispanics (OR=2.20, 95%CI=1.27-3.79, p<0.01) were associated with higher odds for OAD compared to Whites. Individuals covered by Medicaid (OR=2.08, 95%CI=1.26-3.43, p<0.01) and Uninsured (OR=2.27, 95%CI=1.05-4.89, p=0.04) were associated with higher odds for OAD compared to those covered by private insurance. Individuals residing in lowest income households were associated with higher odds (OR=2.60, 95%CI=1.40-4.82, p<0.01) for OAD compared to highest income households. Increase in co-morbid burden was associated with increase in odds for OAD (OR=1.57, 95%CI=1.47-1.68, p<0.001). Those in midwestern (OR=0.39, 95%CI=0.21-0.71, p<0.01) and southern regions (OR=0.30, 95%CI=0.18-0.53, p<0.01) were associated with lower odds for OAD compared to those in western region.
Conclusions: The study revealed that individuals covered by Medicaid, Blacks, Hispanics, those from lowest income households and those with higher co-morbid burden were associated with higher odds of OAD.