TY - JOUR
T1 - Aberrant Opioid Use and Urine Drug Testing in Outpatient Palliative Care
AU - Arthur, Joseph A.
AU - Haider, Ali
AU - Edwards, Tonya
AU - Waletich-Flemming, Jessica
AU - Reddy, Suresh
AU - Bruera, Eduardo
AU - Hui, David
N1 - Publisher Copyright:
© Mary Ann Liebert, Inc.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Aberrant opioid use is a public health issue, which has not been adequately described in the palliative care literature. With the increasing integration of palliative care into oncologic care, palliative care clinicians are seeing patients earlier in the disease trajectory, and therefore, more outpatients with chronic pain requiring chronic opioid therapy. This may have resulted in a concomitant rise in the number of patients with aberrant opioid use. In this article, we report on two patients with aberrant opioid-related behavior seen at our palliative care clinic. A high suspicion of opioid abuse, misuse, or diversion based on certain behavioral cues necessitated the ordering of a urine drug test (UDT). The tests helped the medical team to confirm an already existing pattern of maladaptive opioid use. In both cases, we provided ample opioid education and implemented effective strategies to address their aberrant opioid use. These cases suggest the need for palliative care clinicians to develop strategies to effectively address this issue in our field of medicine. It also highlights the usefulness of UDT in the outpatient palliative care setting.
AB - Aberrant opioid use is a public health issue, which has not been adequately described in the palliative care literature. With the increasing integration of palliative care into oncologic care, palliative care clinicians are seeing patients earlier in the disease trajectory, and therefore, more outpatients with chronic pain requiring chronic opioid therapy. This may have resulted in a concomitant rise in the number of patients with aberrant opioid use. In this article, we report on two patients with aberrant opioid-related behavior seen at our palliative care clinic. A high suspicion of opioid abuse, misuse, or diversion based on certain behavioral cues necessitated the ordering of a urine drug test (UDT). The tests helped the medical team to confirm an already existing pattern of maladaptive opioid use. In both cases, we provided ample opioid education and implemented effective strategies to address their aberrant opioid use. These cases suggest the need for palliative care clinicians to develop strategies to effectively address this issue in our field of medicine. It also highlights the usefulness of UDT in the outpatient palliative care setting.
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U2 - 10.1089/jpm.2015.0335
DO - 10.1089/jpm.2015.0335
M3 - Article
C2 - 27171327
AN - SCOPUS:84976630294
SN - 1096-6218
VL - 19
SP - 778
EP - 782
JO - Journal of palliative medicine
JF - Journal of palliative medicine
IS - 7
ER -