Open AccessEarly palliative care and the opioid crisis: ten pragmatic steps towards a more rational use of opioids
Author(s) -
Jan Gaertner,
Christopher Boehlke,
Charles B. Simone,
David Hui
Publication year - 2019
Publication title -
annals of palliative medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 19
eISSN - 2224-5839
pISSN - 2224-5820
DOI - 10.21037/apm.2019.08.01
Subject(s) - medicine , palliative care , opioid , context (archaeology) , intensive care medicine , medical prescription , prescription drug misuse , psychiatry , nursing , opioid use disorder , paleontology , receptor , biology
In palliative care, opioids and other controlled drugs are among the most commonly used and important medications. Opioids are associated with significant risk of dependence and misuse. In many developed countries, there is an epidemic of prescription opioid misuse and overdose deaths. Palliative care has a critical role educating patients about the safe use of opioids, providing universal screening and close monitoring, and prescribing opioids appropriately balancing the risks and benefits. This is particularly important in the era of early palliative care, when patients have much longer survival and potentially greater risk of misuse while on chronic opioid therapy. Here, we provided a critical appraisal of opioid use in the context of opioid crisis and early palliative care. We also present a pragmatic 10-step approach for the judicious use of opioids.