Drug addiction and cancer are two of the most devastating chronic diseases. The development of treatments for each is in about the same place: We do not know the cause of either disease, but we have methods to treat the symptoms. Continued study and research is getting us closer to a thorough understanding of both addiction and cancer. In the meantime, we are marginally successful at controlling each of them.
Another notable similarity between the two diseases is the mortality rate. Both addiction and cancer present a high risk of death, 100 percent if not treated. When cancer and addiction occur together, the risks are significantly compounded. However, armed with information and a good strategy, you can avoid fighting these two big killers at the same time.
Statistically Significant: Cancer Patients and Drug Addiction
According to data from 2010-2012, the National Cancer Institute estimates that 39.6 percent of American adults will receive a cancer diagnosis at some point in their lives. It estimates that the number of new cases of cancer diagnosed worldwide will reach 22 million in the next 20 years.
Up to two-thirds of people with cancer now live five years or more from their date of diagnosis. This survival rate is up from one-half in 1990, evidence of slow advances in treatment. One of the largest areas of innovation in cancer treatment is pharmaceuticals. The cancer drugs are a $100 billion industry and are expected to increase another 50 percent in the next four years.
The number of American adults addicted to drugs is estimated at around 23.5 million. The potential overlap between people addicted to drugs and alcohol and those diagnosed with cancer suggests that a lot of cancer patients have a history of addiction. Cancer is fought with drugs, and that has more serious implications for patients who are already fighting addiction.
Cancer Patient Substance Abuse
The most obvious connection between cancer and substance abuse is fear. Cancer is a serious illness, and although survival rates are slowly increasing, what most people remember are the tragic stories they have heard. Receiving a cancer diagnosis can be emotionally devastating. Many people assume it is a death sentence, or at the very least they will have to endure life-altering treatments.
People react to stressful situations in life in different ways. Some people turn to faith or find an inner strength to face what comes next, but others opt out. They seek an escape from the emotional pain, they avoid understanding the truth, they want to run and hide from a bad reality. These people are likely to turn to drugs and alcohol as a coping mechanism, and that habit can easily lead to drug addiction in cancer patients.
If someone you love gets a cancer diagnosis, or receives bad news about his progress during cancer treatment, you should understand that he is vulnerable to addiction. By providing support for your loved one, though, you can help him avoid compounding his troubles with drug and alcohol addiction. Here are some ideas for you:
- Be there when you hear the news. No one likes to get bad news, but it is softened with the support of a loving friend at your side. If you cannot be present for the diagnosis or the test results, get there as soon as possible. Either by phone or in person, listen to your friend’s stream-of-conscious reaction to the news. Let him say whatever comes to mind; he needs to get it out.
- Be positive. While your friend may assume the worst, you should keep the glass half full. No matter how bad the prognosis, offer hope that things could turn out better than expected. When the world seems to be coming to an end, we all need at least one cheerleader to help inspire our fighting spirit.
- Suggest a strategy. People who are inclined to escapism miss the details. Encourage your friend to learn more about his situation and work with his doctors on determining the next course of action. By engaging him in positive actions, you can help your loved one feel empowered to control his life. While he is working on a plan and taking the next steps, he will not have as much time to feel sorry for himself.
- Offer diversions. One of the biggest complaints of the terminally ill is that their illness becomes the permanent topic of conversation. Bring other ideas to the table. Talk about regular life activities, old times, mutual acquaintances, anything other than cancer. Plan fun activities that take your loved one’s mind off of disease for a little while. This type of diversion could have the same positive brain chemical effect as escaping into a bottle, but without the dangers.
Having cancer represents one of the most stressful times of a person’s life. Stress is one of the most prevalent triggers for addiction relapse, so someone with a history of addiction who is fighting cancer needs additional support. Before the situation becomes overwhelming, recognize that cancer and addiction are often linked and schedule a meeting with an addiction counselor right away.
Even people without a history of addiction are vulnerable when cancer comes into the picture. It is important to recognize the connection between cancer and addiction and take steps to protect against the development of addiction. Cancer tends to take priority over everything else in life, which is understandable considering the risk. Addiction is a serious and life-threatening disease as well, so take precautions.
Cancer Drugs and Addiction
There are two ways to fight cancer that we know of right now. One is to cut it out and the other is to kill it with drugs. In many cases, a combination of these approaches is used. Drugs that are developed to kill cancer tend to be lethal – they kill cancer cells and healthy cells indiscriminately. This approach seems harsh, but cancer can be devastating, so it is important to go after it aggressively.
Those harsh cancer drugs do not threaten patients with possible addiction, though. That comes from ancillary treatments used to relieve pain. Unfortunately, pain can be a big part of cancer. Modern cancer therapies include pain management techniques that involve some highly addictive drugs.
Doctors have realized in the last several years that pain has a negative effect on healing. While pain is an important response that lets us know there is a problem in the body, it can also create a syndrome that short-circuits the nervous system, doing additional harm to the body. In its simplest form, pain takes energy away from healing.
Opioids are a strong class of narcotics, considered the most effective treatment for chronic pain and cancer pain. Synthesized to mimic compounds extracted from the opium plant, these drugs can be highly addictive. For this reason they are strictly controlled and available only with a doctor’s prescription.
When it comes to controlling cancer pain, opioids are considered safe and effective. They need to be taken according to a doctor’s orders because it is possible to overdose or become addicted. When controlled by a physician, opioids do not pose a serious threat of addiction to cancer patients without a history of substance abuse.
Substance Abuse and Cancer
Substance abuse presents a serious problem in cancer treatment. The use of illicit drugs interferes with cancer treatment and can often increase the side effects of cancer drugs. Even alcohol abuse, something many people consider socially acceptable, can detract from a cancer patient’s chances of beating the disease. Any drugs taken in excess decrease the body’s ability to regulate itself and heal from disease or injury.
Even if your substance abuse is in the past and you are working on a solid, long-term recovery, fighting cancer can present some problems. If you are clean and sober, cancer treatment drugs can have their intended effect unhindered. However, the drugs used to control cancer pain may be a problem for you.
When you have a history of substance abuse, you are much more vulnerable to triggers. You may have overcome your cravings to get high by working your program and avoiding your particular triggers. However, when your doctor gives you opioids for pain – either following cancer surgery or during your course of treatment – those old cravings could come back.
Whether addiction is caused by some innate difference in your brain or abuse of substances permanently altered your brain chemistry, you are especially vulnerable to relapse. It may be simply based on probability, like the fact that someone who has beaten cancer is more likely to get it again. If you have suffered from addiction in the past, you are also more likely to develop it again than someone who has never been addicted.
Opioids, while they are very effective in treating pain, can be especially dangerous for the recovered addict. Addiction is something that happens in the pleasure centers of your brain. The substance you choose to abuse alters your brain chemistry to make it produce more feel-good chemicals. You quickly learn that the high can only be achieved with certain substances. Eventually, your brain gets used to having those substances in your system and it stops producing the feel-good chemicals naturally.
Your brain adapts to a new normal state of being like a habit. When those opioids hit your brain, it is likely to remember your last high, even if it was a long time ago. The cravings could become very strong all over again. Once you have suffered addiction, you are more prone to it than others.
The Good Drugs
In many ways, advances in pharmaceuticals are good for society. They allow people to live longer, more productive and pain-free lives. They prevent disease and help our bodies recover. However, there are side effects to every drug, and for people who are recovered from addiction, certain substances present a bigger threat.
Because they mimic the addictive substance found in opium, opioids are a particular problem for people suffering from or prone to addiction. Opioid pain relievers commonly used for cancer treatment include:
Since these drugs are pain relievers and not specific to cancer treatment, they are also prescribed to control pain after surgery or injuries of any kind. In fact, opioid pain relievers were prescribed 207 million times in 2013. The rate of opioid prescriptions has increased from 76 million in 1991, making them easily available on the street.
Prescription control of narcotics is a good idea, but the doctor cannot follow you home to be sure you take them according to his directions. Often, a prescription is written for the maximum allowable quantity for the convenience of the patient, although she may not need the pain relievers for more than a couple of days.
There is no system in place in this country to collect excess medication. Many people just keep it, use it the next time they have pain or share it with friends, not realizing the dangers of addiction. Prescription drug abuse has increased right along with the number of prescriptions written. Having cancer and being prescribed opioids is just another way to get introduced to this addiction cycle.
What Can Be Done to Prevent Addiction in Cancer Patients
Traditionally, doctors specialize in a particular area of medicine and are not generally well-versed in others. Oncologists treat cancer, and in the case of a dual diagnosis, the caner usually takes priority. Addiction is considered a mental illness, something that psychologists and psychiatrists focus on, and pain management is becoming a specialized field of its own. The proper treatment of cancer in someone with a history of addiction requires the coordination of a number of different specialties.
One of the things you learn in addiction recovery is the importance of honesty. Going forward through your program and long into your recovery, honesty becomes a new habit, an ally and a shield. It is important to be honest with your doctors about your addiction history. Even if their job is to treat your cancer, their work is much more effective when they have all the facts.
One of the hardest things about treating a patient for pain is that the doctor has to rely on the patient’s description of the pain. There are no tests to empirically determine how much pain the patient is experiencing. The doctor becomes the judge of whether the patient is really still in pain or just seeking more drugs for recreational use.
Doctors treating patients who have a history of addiction for any kind of severe pain must also recognize the risks of opioids and weigh those risks against the benefits. If you overcome cancer but develop an opioid addiction, how successful would you say your treatment was? If there are other means of controlling the pain that could be effective, those methods should be explored before resorting to opioids.
If someone you love has a history of addiction and is undergoing cancer treatment, your support could help her successfully use opioid pain relievers without lapsing into addiction. Doctors cannot go home with patients, so you could become an important ally in monitoring the use of medications. Talk with your loved one about joining her team in a more active way. Your role could include:
- Keeping track of the medications at home and dispensing them to her when needed. By keeping the drugs out of her control, you might help her avoid an impulse to overmedicate. Also, keep a pain journal and record her level of pain at certain intervals throughout the day. This data can be important to the doctor, and even you might notice trends that should be addressed.
- Talking with your friend about her anxiety balancing addiction with pain. Giving her a safe sounding board for her feelings will help relieve some tension. It will also make you aware of her situation if cravings return. The sooner any sign of addiction relapse is recognized and addressed, the better the potential outcome.
- Communicating with the prescribing physician on a regular basis. In addition to hearing the patient’s description of her pain, the doctor might be helped by an outside perspective on the situation. Since you know her best, you would be able to give insight into any potential warning signs of possible drug abuse, like changes in mood or behaviors.
Any help you provide to a loved one in this situation should be openly and honestly discussed with her first. It is important to express your desire to help in a compassionate way that shows your love and concern and does not make her feel inadequate or ashamed. It can be hard for people to accept help, especially when that help is around the very sensitive area of addiction.
Drug Addiction After Cancer
Cancer treatment is a difficult journey all its own. Similar to addiction, cancer is a foreign concept to most people. Treatment has to start with a lot of education, and then it is seldom a straight path to recovery. Each cancer patient faces a unique set of circumstances, both physically and emotionally. Like addiction, it can make you feel isolated and even depressed.
It is not so unusual for cancer patients to reach a successful end to their treatments only to realize they have a substance abuse problem. Whether the addiction was caused by pain medications during cancer treatment or developed as a response to extreme emotional stress, it requires its own course of treatment. A continuing addiction can erode the state of good health you just worked so hard to attain.
When you first received your cancer diagnosis, you probably thought the worst. Now you have survived all of that and proven your strength and resilience. Recovering from addiction is very similar. It seems scary at first, but you come to realize the value of the journey. Even on the hard days, something inside you knows you have the strength to prevail.
If you or someone you love is suffering from addiction, either with or without cancer, you should contact 12 Keys. We have the experience and compassion to help you through this difficult time, develop a program to address your individual needs and support you on this journey to a healthy, happy life.
Things happen in life that we have no control over – accidents, diseases, disasters. These situations can lead to stress, anxiety, depression and addiction. Though we cannot control the universe, we do have a chance to take control of our lives and move them in a positive direction. At 12 Keys, we have created a comfortable and supportive environment, a port in the storm, where you can learn to take control of your life. No matter what situation precipitated your addiction, you can learn to build a healthy happy life from here, and we can help.