Patients With Substance Use Disorder

Abstract

Palliative care providers, including physician assistants, frequently encounter substance use disorder (SUD) in patients or their families. Many of these patients with SUD remain undiagnosed at the time of palliative care referral, with most patients with these issues having preexisting conditions. Management of these patients requires proper screening and diagnosis, and teams must establish clear expectations. This chapter teaches palliative care teams to detect SUD and differentiate addiction behaviors from incompletely managed symptoms; diagnose and manage associated psychosocial issues; communicate clear expectations regarding treatment; safely prescribe controlled medications; manage intoxication or withdrawal; and develop plans to deal with drug diversion. Ongoing timely multidisciplinary communication is paramount in managing these challenging illnesses.