•Goal of hospice is to promote a peaceful death and this becomes a challenge in patients who have substance abuse and also whose care givers may be using their opioids for managing their own substance abuse problems. Our discussion involved around identifying these issues in the hospice patients and management of these issues.
•Opioids are the mainstay for management of EOL pain and dyspnea.
•Up to 25% of hospice patients have SUDs.
•Hospices exempt from restrictions like PDMP.
•Most hospices do not have policies or guidelines in place to monitor SUDs.
•Unmanaged SUDs can cause increased suffering, mistrust, tolerance and risk for diversion.
Sharma K. Twin pandemics: Opioid abuse epidemic and COVID 19 pandemic: Addressing substance abuse in the hospice patient. Presentation at AFMC Global Town Hall; March 6, 2022; virtual.