No Patient Left Behind: Integrating Addiction Treatment with Buprenorphine into Your Outpatient Palliative Care Practice (TH316)

Patients with serious illness are not exempt from opioid use disorders raging through our communities. Outpatient palliative care clinicians are increasingly challenged to manage patients with both serious illness and active opioid use disorders. In this population, the use of opioids for pain is particularly complicated, and we struggle to provide safe, rational, and appropriate care. Buprenorphine (brand names include Suboxone, Zubsolv, and Bunavail) is a partial opioid agonist that can be used for maintenance treatment of opioid use disorders in the outpatient setting.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research

Related Links:

The United States continues to face a public heatlh crisis of epic proportion, with over 500,000 deaths from opioid overdoses since 2000. Medications for opioid use disorder, like buprenorphine, offer patients an effective approach to cessation. Unfortunately many barriers to use of medications for opioid use disorder exist, including insufficient number of programs offering medications for opioid use disorder, inadequate number of addiction specialists to provide these medications, and stigma surrouding patients with opioid use disorders and the medications used to treat them.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
It is estimated that approximately 10% of Americans are diagnosed with a past or active substance use disorder (SUD), placing them at risk for related mortality and morbidity. However, when patients face the diagnosis of a serious illness, this new stress places them at even higher risk of substance use disorder relapse. Palliative care teams are frequently consulted to provide care to this complex and vulnerable population, however many lack the training and knowledge to safely provide this care.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Buprenorphine is widely used as a treatment for patients with opioid use disorders, but has also been shown to be an effective treatment for cancer and neuropathic pain, with unique pharmacologic properties that give it several advantages over traditional opioids. Buprenorphine is associated with less analgesic tolerance, and is less likely to cause respiratory depression and constipation than other opioids. Buprenorphine also does not cause immunosuppression, sphincter of Oddi dysfunction, or hypogonadism like traditional opioids.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Pain and opioid management are core ambulatory palliative care skills. Existing literature on how to manage opioid misuse/use disorder excludes patients found in palliative care settings, such as individuals with serious illness (e.g., cancer) or those near the end of life.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Authors: Reed K Abstract The main goal of palliative care is to relieve suffering. Opioids are an essential part of the pharmacological options required to address suffering by helping to relieve the pain and chronic breathlessness that may be experienced by someone with a life-limiting illness. This paper considers the recent history and current issues of the 'opioid crisis' providing recommendations to which regulatory and peak bodies can work with the Australian government, ensuring consistent adherence to WHO guidelines maintaining access to evidence based opioid management for palliative care patients whilst a...
Source: Journal of Pain and Palliative Care Pharmacotherapy - Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research
CONCLUSION: This study highlights the challenge of opioid management in patients with serious illness, particularly when misuse or substance use disorder is present, and suggests areas for future research focus. Our next step will be to establish consensus on approaches to opioid prescribing decision-making and policy in seriously ill patients presenting to ambulatory palliative care. PMID: 31763926 [PubMed - as supplied by publisher]
Source: The American Journal of Hospice and Palliative Care - Category: Palliative Care Authors: Tags: Am J Hosp Palliat Care Source Type: research
Authors: Houchard G, Kullgren J, Saphire M, Porter K, Abel S Abstract Evidence guiding inpatient management of buprenorphine is lacking-this retrospective cohort study evaluated the clinical impact of hospital continuation versus discontinuation of buprenorphine at an academic medical center. The primary outcome was inpatient oral morphine equivalents (OME). Secondary outcomes included patient pain levels, functional assessment, and hospital length of stay. One hundred thirty-one patients (74 continued buprenorphine, 57 discontinued) were included in the analysis. Median OME were significantly lower among patients ...
Source: Journal of Pain and Palliative Care Pharmacotherapy - Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research
Conclusions: Indian medical practitioners felt the need for formal pain management training. There is a lack of consensus on how to manage the pain using opioid analgesics. Tough regulations on medical and scientific use of opioids are the most commonly reported barrier to prescribing them.
Source: Indian Journal of Palliative Care - Category: Palliative Care Authors: Source Type: research
AbstractCancer pain is a common symptom experienced by patients, caused either by the disease or its treatment. Morphine remains the most effective and recommended treatment for cancer pain. However, cancer patients still do not receive appropriate management for their pain, and under-treatment is common. Lack of knowledge and negative attitudes towards cancer pain and analgesia among professionals, patients and family caregivers are reported as one of the most common barriers to effective cancer pain management (CPM). To systematically review research on the nature and impact of attitudes and knowledge towards CPM, a syst...
Source: Journal of Cancer Education - Category: Cancer & Oncology Source Type: research
Opinion statementAlthough clinical evidence supports the use of opioids for cancer-related pain, doing so amidst the current opioid crisis remains a challenge. A proportion of opioid-related deaths in the USA are attributable to prescription opioids, which implicates health care providers as one of the major contributors. It is therefore even more important now for all clinicians to follow safe and effective opioid prescribing practices. Oncologists are often in the frontline of cancer pain management. They are encouraged to use validated tools to screen all patients receiving opioids for high risk behaviors. Those identif...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
More News: Addiction | Pain | Pain Management | Palliative | Palliative Care | Suboxone