• Debra Rodrigue, Jennifer Winkelmann, Maura Price, Eleni Kalandranis, Lisa Klempner, and Neena Kapoor-Hintzen.
• Memorial Sloan Kettering Cancer Center.
• Clin J Oncol Nurs. 2020 Apr 1; 24 (2): 170-176.

BackgroundOpioids are commonly prescribed to manage cancer pain. Similar to the general population, patients with cancer are not excluded from the risk for opioid misuse and dependence. This situation can contribute to clinician reluctance to prescribe and manage pain using opioids.ObjectivesThe purpose of this article is to provide an overview of how opioid misuse may affect pain management in patients with cancer and to describe a comprehensive cancer center's approach to safely managing cancer pain.MethodsBased on a literature review, the project team developed a stewardship program. Project components included selecting a validated screening tool for risk of opioid misuse, determining if a history of addiction affects pain management in patients with cancer, and establishing a task force to focus on the opioid crisis and to follow the Joint Commission's revised pain assessment and management standards.FindingsThe project established a hospitalwide opioid stewardship program. Through the use of a multidisciplinary, universal precautions approach to assessing misuse in all patients with cancer who are prescribed opioids, healthcare teams can potentially reduce risks associated with misuse while safely managing cancer pain.

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