End of life and palliative care of patients with drug and alcohol addiction
Rosie Mundt-Leach Head of nursing, Addictions Clinical Academic Group, Addictions Senior Management Team, South London and Maudsley NHS Foundation Trust
This literature review attempted to identify current knowledge of the end of life care needs of patients with drug and alcohol addiction, particularly in the UK, and to identify any existing good practice guidance.
Three themes emerged: first, the need to improve recognition of substance misuse in patients receiving palliative care, and how to meet the pain management challenges palliative care teams face when caring for patients who have current or past opiate, benzodiazepine or alcohol addictions.
Second, no UK published literature was found that directly addressed the subject of this literature review, but there were some US sources that looked at a family systems approach to the care of dying substance misuse patients, and the role of social workers and methadone counsellors in the care of dying patients receiving opiate substitution treatment.
Third there is inequitable access to end of life and palliative care services for homeless people, many of whom experience addictions.
The author recommends a discussion about what the term recovery can mean when applied to a person with addiction at the end of life, better recognition of approaching end of life in patients with drug and alcohol addictions and closer working relationships between palliative care and addictions services.
Mental Health Practice. 20, 3, 17-21. doi: 10.7748/mhp.2016.e1148Correspondence
This article has been subject to double blind peer reviewConflict of interest
Received: 19 January 2016
Accepted: 06 June 2016