Updated on March 26, 2024
6 min read

How Does Palliative Care Work for Substance Abuse?

When someone living with addiction has a life-threatening illness, their care needs are unique.1 End-of-life care for addicts, also called palliative care, isn't just about medical treatments. It's also about understanding the whole person and providing the best possible quality of life. 

However, stigma can make getting this care difficult. We must remember that addiction is an illness, and everyone deserves compassionate care.3

What Happens in Palliative Care?

Palliative care for people struggling with addiction involves a multifaceted approach that addresses both physical discomfort and the complexities of addiction. 

Here's what families of addicts can expect during this critical phase of care:

Exploring Non-Opioid Options 

In the initial stages, healthcare providers prioritize non-opioid strategies to manage pain. This includes non-opioid pain relievers, physical therapy, and counseling.

The aim is to alleviate discomfort without risking the misuse of stronger medications. Families can expect a thorough exploration of these avenues, emphasizing the importance of finding relief in the safest way possible.

Careful Use and Monitoring of Medications

When stronger medications become necessary, meticulous monitoring and open communication are crucial. This ensures safety and comfort through regular check-ins.

Palliative care is a process that involves the entire healthcare team and the person in need. It focuses on managing pain effectively while minimizing potential risks associated with addiction.

Teamwork and Specialist Support

Addiction specialists may join the healthcare team to offer their expertise, providing additional support and guidance. This collaborative approach ensures that the patient's care plan is comprehensive. It addresses both their palliative and addiction-related needs.

Families should expect a coordinated effort to manage the person’s condition, emphasizing the importance of teamwork in providing optimal care.

Whole-Person Support

Effective palliative care requires a holistic approach. Families should expect a care plan that addresses various health needs.

It involves not just medical treatments but also psychological and social support. This includes the involvement of psychologists, addiction specialists, and social workers.

Prioritizing Comfort and Pain Relief

Despite the complexities of managing addiction, the primary focus remains on alleviating pain and ensuring comfort. 

Since addiction can sometimes make pain meds less effective, healthcare professionals are committed to finding safe options. Families can trust that their loved one's comfort is the utmost priority in palliative care.

Emotional and Psychological Support in Palliative Care for Addicts

The end of life brings up powerful emotions for everyone. With those living with addiction, there can be a mix of guilt, shame, fear, and even a sense of spiritual struggle.

Palliative care helps by:

  • Creating a safe space: Patients need to feel heard and understood, free of judgment. Support might include therapy, support groups, or connecting with someone like a chaplain or spiritual leader.
  • Addressing fears: Many worry about relapse and managing strong pain medication. Honest and open discussions with doctors and the care team can offer some reassurance.4
  • Supporting the family: Addiction creates ripple effects throughout families. Support groups, therapy, and guidance help loved ones cope and support their family member navigating a serious illness.

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Family Support and Involvement in Palliative Care

Families are vital for the end-of-life care of those with addiction. They face stigma and stress, but palliative care helps. Teams educate families, encourage open communication, and offer emotional support. 

Through palliative care, families are involved in care decisions, with their knowledge respected. Addiction specialists work with teams to address unique needs, overcome stigma, and manage pain safely. 

In addition, grief support is available in palliative care. This helps families cope after their loss.

Commonly Used Medications in End-of-Life Palliative Care

Some commonly used medications in end-of-life palliative care include:

Symptom/ConcernMedication TypesNotes
PainOpioids (e.g., morphine, fentanyl)For moderate to severe pain, may ease breathlessness
Non-Opioid Analgesics (e.g., acetaminophen)Mild to moderate pain, common in hospice care
Adjuvant Analgesics (NSAIDs, steroids, antidepressants, anticonvulsants)Can be helpful for bone/nerve pain
Anxiety/AgitationAnxiolytics (e.g., lorazepam)Manage anxiety and agitation
Antipsychotics (e.g., haloperidol)Treat delirium and agitation
Nausea/VomitingAntiemetics (e.g., prochlorperazine)
Respiratory DistressAnticholinergics (e.g., atropine)Reduce excess mucus alleviate breathing difficulties
Opiates (e.g., morphine)Can decrease the feeling of air hunger
Other SymptomsAntidepressantsHelp manage depression
CorticosteroidsAnti-inflammatory, helps reduce swelling 

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How to Find an End-of-Life Facility For Addicts

Finding compassionate, specialized care for someone facing a life-limiting illness while also living with addiction is a difficult but essential task.

Here's a detailed guide to locating an appropriate facility:

1) Assess Needs

Pain management for people with addiction needs to be tailored to each person. Doctors first consider the cause of pain and any other health problems. 

They also assess the type and severity of the addiction, as this can affect how someone feels pain and responds to medication. With this knowledge, doctors can create a safe pain management plan that doesn't involve risky medications.

2) Research and Find Specialized Facilities

Seek facilities offering palliative care for patients with SUD. These places are better equipped for the challenges surrounding addiction and end-of-life care.

Check if these facilities have dedicated programs within their palliative care services to meet the specific needs of individuals with SUD. This can include having staff with credentials in addiction medicine and palliative care.

Choose facilities with appropriate accreditations demonstrating a commitment to quality care. You can also explore online resources like directories for SUD-specialized palliative care centers.

Some helpful sources include:

3) Care Approach

It’s best to look for facilities offering a multidisciplinary approach. Facilities should involve doctors, nurses, social workers, chaplains, and possibly volunteers, all trained to work with those facing SUD.

You should also prioritize facilities with open communication about end-of-life preferences for patients and their families. Inquire about non-opioid pain management options along with strategies for safe opioid use when necessary.

4) Practical Considerations

When choosing a facility, you should also consider the following:

  • Visitation: Arrange a facility tour to observe the environment, meet staff, and learn about their care delivery process.
  • Referrals: Healthcare professionals, addiction specialists, social workers, and SUD support groups can offer referrals to trusted facilities.
  • Insurance and Affordability: Ask about coverage, out-of-pocket costs, and potential financial aid options.
  • Location: Ensure the facility is accessible for family visits.
  • Aftercare Support: Choose a facility offering bereavement support to the family of the deceased.

Who Is Involved in a Palliative Care Team?

An entire team provides well-rounded support tailored to a patient's needs and stage of illness.6 These include:

Doctors, PAs, and Nurses

Various medical professionals manage symptoms, coordinate care, and stay on top of overall health. Nurses especially tend to provide the bulk of hands-on daily care.

Allied Health Professionals

This is a large umbrella that includes social workers, counselors, physical therapists, spiritual care workers (chaplains), dietitians, and more. They support mental health, help navigate resources, and ensure physical needs don't go overlooked.


Trained volunteers add another layer of support by offering companionship, practical assistance at home, and respite for caregivers.

This team's purpose is clear: make life the best it can be for the patient and their loved ones. Together, they focus on communication, addressing emotional needs, and ensuring wishes are carried out as much as possible.

Compassionate care is key for those with addiction facing a terminal illness. Palliative care teams understand these needs and offer a safe space, honoring patient and family wishes.

While overcoming stigma and prejudice toward those with addiction can be a hurdle, it's never too late to seek out supportive, dignified care when life's journey is coming to its end.

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Updated on March 26, 2024

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