Current Status of Cancer-Related Pain and Opioid use in South Lebanon: A Pilot Study

Fadi S Farhat 1 2Mohamed Tarabey 1Feras Chehade 3Tarek Assi 2Joseph Kattan 4

Affiliations

1Department of Hematology-Oncology, Hammoud Hospital University Medical Center, Saida, Lebanon.

2Department of Hematology-Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.

3Department of Nuclear Medicine, Hammoud Hospital University Medical Center, Saida, Lebanon.

4Department of Hematology-Oncology, Hôtel-Dieu de France University Hospital, Beirut, Lebanon.

PMID: 33431363

Abstract

Objective: This study aimed to evaluate the patients and health providers’ (doctors and nurses) knowledge and understanding of the disease-related pain, and the perception of pain drugs (opioids) in South Lebanon.

Patients and methods: This was a pilot study conducted at different hospitals in South Lebanon among patients with confirmed cancer diagnosis and providers. Data was collected using patients’ and providers’ questionnaires.

Results: 43 patients and 42 providers were included. 22 (52%) patients were male. Nine (21%) patients were aware of their diagnosis and only 60% talked about their pain to their oncologist. Pain was not optimally controlled with 25 (58%) patients having uncontrolled pain and 18 (42%) patients having continuous pain. Morphine was negatively perceived with 55.8% of patients believing that morphine causes addiction and 59% taking pain medications only when the pain is maximal. This led to a 58% short duration control of intermittent pain. 60% of the providers were certain that cancer pain cannot be relieved by morphine while only 33% believed that morphine can cause complete relief. Addiction seemed to be the main obstacle for morphine use with 37 (89%) thinking that narcotics causes addiction and 51% considering morphine withdrawal if side effects appear. Finally, 30% suggested to discontinue morphine in the terminal stages of cancer.

Discussion and conclusion: Major misconceptions in cancer patients are observed in the approach to antalgic treatment in our population. With good education, better knowledge and optimal palliative care units, misconceptions about opioids can be corrected with best management of cancer pain.