Providing palliative care for terminally ill patients with drug addiction is
a major challenge for medical professionals. Very little has been done to focus
on this special population of end-of-life care patients. This review article
attempts to explore terminology and definitions for identifying addiction in
the terminally ill and management options. Terms such as "physiological
dependence" and "tolerance" are inappropriate for use with this
population and have little utility for identifying problems because these patients
are likely to have been on opioids for extended periods and require dose escalation
for progressive disease. The authors recommend understanding the context of
the drug abuse as it reflects on the concepts of use despite harm and the damage
inflicted to the physical, psychological, or social make-up of the patient.
Recommendations include careful monitoring and assessment, using a multidisciplinary
approach, encouraging participation in recovery programs, and utilizing pill
counts and urine toxicology screenings. Implications for practice are discussed.
Kirsh KL, Passik SD. Adapted from Cancer Invest. 2006 Jun-Jul;24(4):425-31.
Read more: PMID 16777696
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Credit: PubMed, developed by the National Center for Biotechnology Information
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National Library of Medicine (NLM).
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