Practice Innovations

Substance Use and Misuse: A Pilot Study to Improve Screening and Interventions at a Comprehensive Cancer Hospital

Gretchen A. McNally

Fayona D. James

Jodi Gilliam-Harmon

Saquena Atkins

Dori Klemanski

substance use disorders, addiction, Screening, cancer, harm reduction
CJON 2021, 25(5), 601-604. DOI: 10.1188/21.CJON.601-604

Mounting evidence suggests patients diagnosed with cancer may be at increased risk for opioid misuse and diversion. Substance use disorders (SUDs), involving prescription medications and/or illegal substances, may significantly compromise the ability of healthcare professionals to deliver high-quality cancer care. A substance use screening pilot was conducted in ambulatory oncology clinics at a large cancer hospital in the midwestern United States. In this article, the authors present results from this quality improvement project. Future directions involve innovative methods to deliver addiction-specific knowledge to oncology healthcare providers and should focus on discussing screening results, as well as providing tailored recommendations using shared decision-making with patients and caregivers.


  • SUDs may not be uncommon in patients with cancer.
  • Nurses closely interact with patients and may be the first oncology provider to suspect harmful substance use.
  • Screening for substance use in patients with cancer allows for the early detection of and risk mitigation for concomitant substance misuse or addiction.
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