The links between substance abuse and various forms of cancer are multiple and multidirectional. Just as many drugs pose real cancer risks, cancer patients are often particularly vulnerable to developing chemical dependence.
In some cases, these troubling ties have been exhaustively researched over several decades.
Alcohol abuse, for example, is associated with a staggering array of cancer concerns. In other areas, these connections are the subject of ongoing controversy.
In this article, we’ll survey the latest medical findings related to connections between substance abuse and cancer. First, we’ll discuss why cancer patients often face particular risks related to compulsive drug use. Next, we’ll explore how specific substances leave users vulnerable to developing cancer, especially when used over extended periods of time.
Ultimately, we hope this information will help more individuals embrace healthy approaches to recovery – from substance abuse, cancer, or both.
Cancer is a strikingly diverse illness, encompassing a vast array of related conditions across the human body.
At a fundamental level, cancer refers to out-of-control cell division. As cells rapidly reproduce and grow, they cause tumors, immune system issues and other types of bodily harm.
Unfortunately, cancer is also disturbingly prevalent.
According to the American Cancer Society, an estimated 1,735,350 new cancer cases were diagnosed in the U.S. in 2018.
Additionally, the organization estimates that 609,640 cancer deaths occurred in that year.
Thankfully, however, new preventative approaches and treatment technologies have radically improved many cancer patients’ odds of recovery.
Today, among American adults diagnosed with cancer, the five-year survival rate is 68 percent. For some of the most common variants, such as breast or prostate cancer, the survival rate is far higher. Relative to decades past, these data represent huge leaps in modern healthcare.
Yet for cancer patients and survivors, the repercussions of their illness are often quite serious. And while the symptoms associated with various kinds of cancer differ, many report considerable pain in treatment and remission.
For individuals actively receiving cancer treatment, pain can be virtually constant.
In one massive literature review of 122 existing studies conducted in 2016, researchers established the following estimates for pain prevalence:
Additionally, 38 percent of these cancer patients reported that their pain was a five or higher on a scale ranging from 1 to 10. This pain could stem either from the effects of the disease itself, or various treatments (such as chemotherapy) intended to halt its progress.
In recent decades, the medical establishment has attempted to aid cancer patients facing debilitating pain each day.
Whereas physicians had previously avoided painkillers whenever possible, pain relief emerged as a new priority in 21st century medical care. As a result, patterns in opioid prescribing shifted rapidly, driven by the aggressive marketing efforts of major pharmaceutical companies.
In many cases, cancer patients and survivors found much-needed relief in opiods, using them as prescribed in order to meet the demands of their daily lives. Indeed, some experts assert that cancer pain remains widely undertreated, and that increased access to pain medication would alleviate unnecessary suffering.
Yet alongside these success stories, darker narratives emerged as well.
First, much research cautions against opioids as a primary treatment option for chronic pain. Other methods can prove more effective and carry significantly fewer risks.
More importantly, experts observed a massive tragedy unfolding. Using opioids for extended periods on ever-higher doses, a significant portion of cancer patients were becoming dependent upon these drugs.
Relatively little research has explored the prevalence of substance use disorders among cancer patients and survivors. Yet experts in oncology report that substance abuse is a growing concern across their field.
Much like those with other kinds of pain, cancer patients find themselves requiring increasingly potent doses as their tolerance grows over time.
Over time, physical and psychological dependence deepens, resulting in excruciating withdrawal symptoms whenever opioids are removed. Cravings for chemical relief may lead patients to take painkillers more often than recommended, or snort or inject them for maximum effect.
In one 2013 study of 522 cancer patients, medical researchers found that 29 percent were at high risk for misusing opioids. A 2015 experiment evaluated 432 patients, finding that 18 percent were “chemically coping” – using opioids or other substances in response to stressful events, rather than as prescribed.
More recently, leading voices in the field of oncology have begun to address risks associated with opioids.
In a 2018 article in the New England Journal of Medicine, Dr. Alison Loren, a professor at the University of Pennsylvania School of Medicine, described witnessing her patients become hooked on painkillers. Noting the complexity of these cases, Dr. Loren called opioid use disorder in cancer patients “harder to treat than leukemia.”
For some experts, substance abuse is the predictable byproduct of widespread cancer pain and increased opioid availability. According to Judith A. Paice, director of the Cancer Pain Program at Northwestern University, “Two public health crises, the epidemics of chronic pain and of opioid misuse, are creating challenges for cancer pain management.”
As Paice notes, the medical community overlooked the potential for abuse and dependence among cancer patients. “Many people have assumed that people with cancer are not at risk for addiction,” she said in a recent interview. “When in fact they may have the same risk as, or possibly even a greater risk than the general population.”
Among cancer patients and survivors, the risks of substance abuse don’t end with opioids.
Indeed, the psychological impact of a cancer diagnosis can be staggering, combining physical pain with mental turmoil. Because cancer treatment entails much uncertainty and many difficult outcomes, patients may seek solace in intoxicating substances of any kind.
In fact, clinical depression is roughly four times more common among cancer patients than in the general population. Anxiety is more prevalent among those with cancer as well.
Moreover, experts say that the mental health challenges associated with a cancer diagnosis can often occur after treatment has ended. That is, once the crisis seems over, distress sets in.
These data points are relevant because of the undeniable links between depression, anxiety and substance abuse. Because depressed or anxious thinking can cause, complicate or exacerbate substance abuse, cancer patients may face additional risks of chemical dependence.
Thankfully, cancer patients and survivors who become addicted to substances are not doomed to continual dependence. With the right medical supervision and complementary support, even those with severe chronic pain can detox safely and pursue lasting recovery.
At the outset, however, it’s important to convey just how intensive and extended some of these treatment approaches can be. Weaning off drugs safely is no overnight matter, especially for those with recurring cancer pain.
According to CDC guidelines, patients who wish to reduce or eliminate their opioid consumption should taper their use strategically over a considerable period of time.
This approach can be highly incremental. While some may succeed by reducing their dose by 10 percent each week, others may need a 10 percent decrease each month, instead.
The CDC’s guidelines are also explicit about the necessity of psychosocial support. Without therapy or other forms of substance abuse treatment, the taper is unlikely to succeed.
Additionally, these resources may offer cancer patients an opportunity to explore the issues underlying their use, whether directly related to their illness or otherwise.
In light of these guidelines and our own expertise in chronic pain, our treatment team provides patients medical and therapeutic support throughout the detox process.
Unlike those who attempt to reduce their dosage on an outpatient basis, individuals in our detox facilities benefit from constant supervision and support. That means they can detox more quickly, safely and with significantly less discomfort.
Of course, even once substance abuse issues are treated, cancer pain may remain. Accordingly, it is essential to explore non-addictive alternatives for managing pain moving forward.
While each patient’s needs will necessarily differ, there are many proven alternatives to opioids worth exploring. These solutions include holistic and high-tech options with varying costs, such as:
While we can’t offer precise medical advice, cancer patients should discuss these options with their own physicians, determining which are most likely to yield relief.
Additionally, the array of evidence-based treatments for chronic pain is continually expanding, presenting cancer patients with greater choice than ever before. In this regard, it’s important to seek supportive medical help.
Your doctor should help you evaluate your pain management strategy, rather than insist on pain medication from the outset.
Intoxicating substances affect the body in distinct and dangerous ways. Accordingly, it’s imperative to explore the specific cancer risks associated with several drugs, noting the physical harms inflicted by each intoxicant.
Below, we’ll enumerate the particular kinds of cancers associated with the use or abuse of multiple substances. While we’ll primarily emphasize established connections, we will also note some instances in which ties seem probable or possible. We do so in order to help users understand the potential health risks associated with their behaviors – and perhaps seek treatment as a result.
We hope this article illuminates the ties between substance use disorders and cancer, detailing how each illness might contribute to the other.
Ultimately, both conditions are complex and chronic, re-emerging across the lifespans of many patients. At an individual level, cancer and substance abuse may repeatedly entwine, raising difficult questions.
Is a cancer patient’s reliance upon pain medication evidence of addiction? Should individuals with histories of substance abuse avoid using opioids to treat cancer pain? What is the best pain management approach, even if it fails to eliminate suffering entirely?
These questions cannot be dealt with in general terms. Appropriate determinations must be made by individual patients and healthcare professionals.