Opioid, non-opioid, and non-pharmacological pain management in patients with a history of cancer.

Pain management is a critical component of cancer care, yet the influence of sociodemographic and clinical factors on prescribing patterns for opioids, non-opioid medications, and non-pharmacological interventions remains underexplored. This cross-sectional study using the 2018-2020 Medical Expenditure Panel Survey (MEPS) characterizes clinical and sociodemographic factors associated with opioid, non-opioid, and non-pharmacological pain management in individuals with a history of cancer. Adults aged ≥18 years with a self-reported cancer diagnosis (N = 7,035) were characterized by sociodemographic factors, including race/ethnicity, income, insurance type, and English proficiency, and clinical variables such as cancer type, comorbidities, and depression were surveyed. Main outcomes included receipt of prescription opioids, non-opioid pain medications, and non-pharmacological pain interventions. Adjusted relative risks (aRR) for pain management approaches were estimated using quasi-Poisson regression. Among 7,035 participants, 19.99% received opioids, 51.15% non-opioid medications, and 20.73% non-pharmacological interventions. Opioid prescription was significantly lower among Asian participants (aRR 0.18, 95% CI 0.05, 0.67) and those with limited English proficiency (aRR 0.22; 95% CI 0.11, 0.43). Depression was associated with increased use of opioids (aRR 1.26, 95% CI 1.09, 1.46) and non-opioid medications (aRR 1.26, 95% CI 1.18, 1.34). Non-opioid and non-pharmacological interventions were more likely among females (aRR 1.21 and 1.49, respectively) but less frequent among individuals with lower income and education. Significant differences in cancer pain management were found based on sociodemographic and clinical factors. Further research is needed to determine whether disparities in opioid and non-opioid prescribing persist across race, sex, English language proficiency, and mental health comorbidities.