Attitudes and Experiences of Palliative Care Providers Toward Patients with Substance Use Disorder

Abstract

As the U.S. population ages and older adults use substances at unprecedented rates, more patients with substance use disorder (SUD) will require medical care for serious illnesses. Despite shifting demographics and population care needs, there is a paucity of research on palliative care for patients with SUD. The limited literature at the intersection of palliative care and patients with SUD focuses on the challenges of safely prescribing to patients, excluding any other elements of care for this patient population. The current study is the first to explore the attitudes and experiences of palliative care providers of different disciplines toward patients with SUD. This research utilized an exploratory, qualitative methodology with semi-structured interviews with 14 interprofessional palliative care providers. Several salient themes emerged following a thematic analysis of interviews: the distinct roles and values of palliative care, the perception of patients with SUD as complex with complex care needs, awareness of stigma and desire to reduce impacts on patients, the multivariate factors that influence the development of SUD, and a spectrum of care strategies and identified training needs. The results of this study establish there are other relevant considerations for palliative care patients with SUD in addition to safe prescribing. Due to the lack of a comprehensive approach for palliative care patients with SUD, this study supports the need for further resources and training opportunities for providers. Patients with SUD also experience systemic marginalization, pointing to a need for greater structural shifts to reduce barriers to adequate care.