Table 1.

Characteristics of the 12 included studies

Author, year	Title	Objective	Time, study design and appraisal score	Setting and sample	Opioid use	Opioid misuse and associated factors
Bertrand, 2016	Does consumption of tobacco, alcohol, and cannabis in adolescents and young adults with cancer affect the use of analgesics during hospitalizations?	To examine how exposure to tobacco and/or cannabis and/or alcohol is associated with opioid analge sics in AYAs with cancer during hospitalizations	6 months during 2013 Cross-sectional survey JBI Score 5	Two cancer centers in France N= 30 age 15–25 years with cancer, active therapy	40% of low-use consumers and 79% high-use consumers (of alcohol and tobacco) self-reported taking opioids	N/A
Cheung, 2020	Prescription Psychoactive Medication Use in Adolescent Survivors of Childhood Cancer and Association With Adult Functional Outcomes	To estimate the prevalence of psychoactive medication use in adolescent survivors of childhood cancer and its associations with functional outcomes at young adulthood	Diagnosed with cancer between 1970 and 1999 Retrospective case control JBI Score: 7	The Childhood Cancer Survivor Study N = 5665 survivors of childhood cancer ages 13–16 years; N = 921 siblings	5.7% of survivors compared to 1.7% of siblings (p < .001) self-reported using opioids for > 1 month in the prior 2 years	N/A
Ehrentraut, 2014	Opioid misuse behaviors in adolescents and young adults in a hematology/oncology setting	To examine opioid misuse behaviors in AYAs treated for cancer at a large, pediatric oncology center and to identify risk factors for aberrant use	Jan 2012-May 2013 Retrospective cohort JBI Score: 7	TN, USA N = 398 age 12–33 years with cancer, active therapy	24% were prescribed opioids	12% exhibited aberrant behaviors No significant association between aberrant behaviors and MH/family hx of SU but trend toward significance (p = 0.06)
Getz, 2018	Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia	To examine opioid prescribing and utilization for children with newly diagnosed AML	2000–2014 Retrospective cohort JBI Score: 8	PHIS database N = 1600 age 1–20 years with AML, active therapy	78% received opioids	N/A
Hewitt, 2008	Opioid Use in Palliative Care of Children and Young People with Cancer	To examine opioid use for children and adolescents with cancer during the last month of life	20-month period Prospective, longitudinal cohort JBI Score: 6	3 cancer centers in UK N = 185 age 0–19 years, end-of-life	90% received opioids	N/A
Madden, 2020	Patterns of Storage, Use, and Disposal of Prescription Opioids by Parents of Children with Cancer	To describe opioid use and storage patterns reported by parents of children with cancer	Feb-Nov 2018 Cross-sectional survey JBI Score: 6	TX, USA N = 109 parents of children age <18 years with cancer, active therapy	97% self-reported their chil dren used opioids	90% did not store safely; 21% did not use safely with patient; 6% gave to other than patient
Monteiro, 2005	Clinical Aspects and Treatment of Pain in Children and Adolescents with Cancer	To examine pain control and analgesic prescribing for children and adolescents with cancer and non-procedure related pain	2000–2003 Prospective, longitudinal cohort JBI Score: 7	Pediatric hospital in Brazil N = 135 age 1–20 years, active therapy	88% received opioids	N/A
Murphy, 2019	Pain and opioid prescriptions vary by procedure after breast surgery.	To examine post-operative pain and opioid prescribing for women after breast surgery	2010–2016 Retrospective cohort JBI Score: 8	3 cancer centers in US N = 4021 18 years+ women s/p mastectomy (5% age 18–39 years)	94% were prescribed opioids	22% received higher discharge dose (Q4 MME) Age 30–39 y had 1.85 higher odds of receiving higher dose compared to age > 80 years (p < 0.05)
Orsey, 2009	Variation in receipt of opioids by pediatric oncology patients who died in children’s hospitals	To describe daily opioid use compared to intermittent use during last week of life for children with cancer who died in the hospital	2001–2005 Retrospective cohort JBI Score: 7	PHIS database N = 1466 age 0–24 years with cancer, end-of-life	56% received daily opioids	N/A
Smitherman, 2018	Early Post-Therapy Prescription Drug Usage among Childhood and Adolescent Cancer Survivors	To examine prescription types and quantities for survivors of childhood cancer	Completed treatment between 2000 and 2011 Retrospective case control JBI Score: 8	Marketscan database N= 1414 mean age 9.3–17.4 years at least 3 years off-therapy	12–46% were prescribed opioids by disease type (highest proportion in bone tumors)	N/A
Thienprayoon, 2017	Risk Stratification for Opioid Misuse in Children, Adolescents, and Young Adults: A Quality Improvement Project	To use an opioid bundle to increase risk stratification for opioid misuse among patients who present for follow up with Pediatric Advanced Care Team	2014–2015 Prospective, pre-post JBI Score: 6	Single cancer center in OH, USA N = 106 age 3–33 years with cancer/BMT; n = 62 were risk-stratified, active therapy	58% received opioids	34% were classified as high-risk for opioid misuse
Wright, 2019	Use and Misuse of Opioids After Gynecologic Surgical Procedures	To examine the rate of opioid use for gynecologic surgical procedures and to investigate persistent opioid use among those women who received an initial opioid prescription	2009–2016 Retrospective cohort JBI Score: 7	Marketscan database N = 729,000 women 6.1% age 18–29 years 25.1% age 30–39 years	Among 18–29 years: 64.5% were prescribed Among 30–39 years: 63.1 % were prescribed opioids	Among 18–29 years: 9.8% were new, persistent users post— operatively Among 30–39 years: 7.7% were new, persistent users post— operatively Younger patients, Medicaid recipients, and patients with depression, anxiety, and substance use disorder all associated with new persistent use (p < .001)