Substance Use Disorders 101 for the Palliative Care Specialist (FR417)

Abstract

•Learn how to identify behaviors affiliated with substance use disorders in the patient with advanced illness.•Understand the tools used to screen for substance use disorders.•Learn symptom management in patients facing serious illness who have a concurrent or historical substance use disorder. Experts in neuroscience and medicine recognize substance use disorders as a brain disease. Current definitions describe substance use disorders as “a primary, chronic, neurobiologic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations.” Manifestations include behaviors such as: impaired control over drug use, compulsive use, continued use despite harm, and craving. Unaddressed substance use disorders perpetuate patient suffering and can devastate caregivers and families. Concurrence with serious illness complicates symptom and disease management and can interfere with care plan adherence. Uncontrolled substance use disorders can considerably reduce quality of life and often contribute to isolation, dysphoria, and anger. Serious illness itself serves as a stressor, and those in this population tend to have aberrant coping skills. Medications commonly used to control symptoms may be close to or a source of the patient’s addictive triggers, creating further medical treatment complexity. Enlisting friends and family in critical decision making may be impossible due to the distance substance use disorders create among the patient and loved ones. A panel of palliative care experts on substance use disorders will use case presentation, didactics, and audience participation to enable attendees to: 1) Develop skill at differentiating pseudoaddictive from substance use disorder behaviors. 2) Understand the neurobiologic and physiologic changes that are characteristic of substance use disorders. 3) Learn how to screen for substance use disorders. 4) Develop skill at managing pain and mood symptoms in this patient population. 5) Recognize when and if one should get an addiction specialist involved. 6) Identify recovery tools that can help the patient and loved ones.