Nationwide registry-based study of temporal trends in opioid use after breast cancer in Denmark

Adequate pain management can be a challenge in care for breast cancer survivors. Opioids are important for acute and chronic pain, yet prolonged use carries risks of dependence and overdose. A nationwide registry based study of 84,160 Danish women diagnosed with stage I-III breast cancer diagnosed between 1997 and 2020 investigated temporal trends in opioid-prescribing. Within one year of diagnosis, 18% of women filled at least on opioid prescription; this proportion declined steadily after 2015. Codeine was gradually replaced by tramadol, morphine, and oxycodome. Across the cohort, 6.1% had long-term use, 2.0% long-term strong use, 3.6% concurrent opioid and sedative-hypnotic use, and 0.4% developed a substance-related disorder or overdose. Among 74,771 opioid-naïve patients, 1.7% became new and prolonged users. Odds of these opioid-related behaviors were higher among women with socioeconomic hardships, psychiatric morbidity, comorbidity, and advanced disease. The authors conclude that opioid use after breast cancer was uncommon and declined over time in Denmark. Nonetheless,social and clinical disparities persisted, highlighting the importance of survivorship care that balances safe prescribing with adequate pain management.