Palliative Care for Patients with Substance Use Disorders: Challenges and Opportunities

People with a substance use disorders (SUD) are more likely to develop chronic, life-threatening conditions and die earlier than the general population. Some of the contributing factors include barriers to healthcare access, negative healthcare experiences, as well as poor social support due to stigma and other drug-related morbidities and mortality. There is a dearth of literature on palliative and end-of-life care for patients with substance use disorders and/or serious mental illness. It has been a challenge for both, medical and mental health providers to navigate important decisions for this vulnerable patient population. Patients with substance use disorders often struggle with social and financial issues, that further hinder access to medical care, and more so, palliative care. In this session, the presenters will use case studies and literature review to familiarize the audience with the unique challenges faced by patients with substance use disorders having co-morbid psychiatric and medical conditions. Specifically, the audience will learn about nuances in a forensic setting. Presenters will highlight barriers to accessing hospice services. Some of the neurobiological and psychosocial factors undermining early access of care will be illustrated through case examples. Small group discussions and role-playing techniques will be utilized to demonstrate major concepts. Lastly, the presenter will emphasize the ethical considerations for patient safety and quality of life, along with the best practices to achieve this goal. Early advance care planning, working with a multidisciplinary team, and building collaborations with the community medical providers, becomes indispensable. The role of palliative psychiatry will be highlighted in a way that views addiction as a potentially fatal illness, and how it can be addressed as such by all healthcare providers.