Association of severe pain with poor response to opioids, psychological distress, and aberrant drug taking behaviors in a large cohort of cancer patients.

9600 Background: Pain is one of the most feared consequences of cancer. Systematic reviews indicate opioids are effective for cancer pain, but are often under-utilized. At the same time, there is increased societal concern about opioid abuse. Identifying patients with a history of cancer who are at risk for poor pain outcomes is important when considering opioid therapy. The aim of this study was to evaluate associations between pain intensity, analgesic effectiveness, disability, distress and aberrant drug taking in the subpopulation from Memorial Sloan Kettering Cancer Center of a pain clinic registry. Methods: At each outpatient encounter, patients completed the Brief Pain Inventory, Condensed Memorial Symptom Assessment Scale (CMSAS) and Current Opioid Misuse Measure (COMM). Though not yet validated in patients with cancer, in other chronic pain populations a COMM score greater than 9 has a positive likelihood ratio for diagnosing opioid misuse/abuse of 3.5. Data analysis performed by International Se...