Medication misuse and illicit substance use among palliative care patients in German palliative care units– an evaluation from the perspective of palliative care providers

Abstract Background Palliative care focuses on controlling symptoms and improving the patient’s quality of life. To achieve this, medications with addictive potential are often used. There have been various case reports of substance misuse in palliative care. This study aims to explore how practitio...

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Main Authors: Jannis Eersink, Julian Maul, Nils Heuser, Astrid Morin, Martin Gschnell, Christian Volberg
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Addiction Science & Clinical Practice
Subjects:
Online Access:https://doi.org/10.1186/s13722-025-00560-3
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author Jannis Eersink
Julian Maul
Nils Heuser
Astrid Morin
Martin Gschnell
Christian Volberg
author_facet Jannis Eersink
Julian Maul
Nils Heuser
Astrid Morin
Martin Gschnell
Christian Volberg
author_sort Jannis Eersink
collection DOAJ
description Abstract Background Palliative care focuses on controlling symptoms and improving the patient’s quality of life. To achieve this, medications with addictive potential are often used. There have been various case reports of substance misuse in palliative care. This study aims to explore how practitioners perceive the issue and management of substance misuse in palliative care patients. Materials and methods Following an extensive literature review, a 23-question questionnaire was developed to assess attitudes and practices related to substance misuse in palliative care and distributed to all German palliative care units (PCUs) listed on the website of the German Society for Palliative Medicine (n = 334). Results A total of 116 responses from PCUs (34.7%) were included in the analysis. Of these, 49.1% estimated that approximately 1–5% of their patients suffer from medication-related substance misuse. Most respondents (72.4%) assumed that 1–5% of their patients use illicit substances. In addition, 62.9% of the PCUs do not screen their patients for substance use disorders, while only 0.9% report doing so regularly. In the case of addiction problems, 55.2% of the PCUs do not implement any specific measures. Most respondents described their approach to prescribing medications with potential for substance misuse as liberal (71.6%) or very liberal (12.9%). Furthermore, 78.4% reported that the addictive potential of a medication has little or no influence on their prescribing decisions. Finally, 67.2% of participants expressed a desire for more education about addiction in palliative care. Discussion The data collected in our study indicate that, from the perspective of palliative care professionals, substance use disorders are not perceived as a significant problem for patients receiving inpatient palliative care. However, we found that most PCUs do not screen their patients for substance misuse, suggesting that most practitioners may not have a comprehensive view of the actual number of dependent patients. Further research is therefore needed to obtain reliable data on the number of patients with substance use disorders in palliative care and to determine the point at which substance misuse is caused by medical prescription.
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spelling doaj-art-2434daafde3045469d2d1510ee42dc652025-08-20T03:04:51ZengBMCAddiction Science & Clinical Practice1940-06402025-03-012011910.1186/s13722-025-00560-3Medication misuse and illicit substance use among palliative care patients in German palliative care units– an evaluation from the perspective of palliative care providersJannis Eersink0Julian Maul1Nils Heuser2Astrid Morin3Martin Gschnell4Christian Volberg5Department of Anaesthesiology & Intensive Care Medicine, Philipps University of MarburgDepartment of Anaesthesiology & Intensive Care Medicine, Philipps University of MarburgDepartment of Anaesthesiology & Intensive Care Medicine, Philipps University of MarburgDepartment of Anaesthesiology & Intensive Care Medicine, Philipps University of MarburgDepartment of Dermatology and Allergology, Faculty of Medicine, Philipps University of MarburgDepartment of Anaesthesiology & Intensive Care Medicine, Philipps University of MarburgAbstract Background Palliative care focuses on controlling symptoms and improving the patient’s quality of life. To achieve this, medications with addictive potential are often used. There have been various case reports of substance misuse in palliative care. This study aims to explore how practitioners perceive the issue and management of substance misuse in palliative care patients. Materials and methods Following an extensive literature review, a 23-question questionnaire was developed to assess attitudes and practices related to substance misuse in palliative care and distributed to all German palliative care units (PCUs) listed on the website of the German Society for Palliative Medicine (n = 334). Results A total of 116 responses from PCUs (34.7%) were included in the analysis. Of these, 49.1% estimated that approximately 1–5% of their patients suffer from medication-related substance misuse. Most respondents (72.4%) assumed that 1–5% of their patients use illicit substances. In addition, 62.9% of the PCUs do not screen their patients for substance use disorders, while only 0.9% report doing so regularly. In the case of addiction problems, 55.2% of the PCUs do not implement any specific measures. Most respondents described their approach to prescribing medications with potential for substance misuse as liberal (71.6%) or very liberal (12.9%). Furthermore, 78.4% reported that the addictive potential of a medication has little or no influence on their prescribing decisions. Finally, 67.2% of participants expressed a desire for more education about addiction in palliative care. Discussion The data collected in our study indicate that, from the perspective of palliative care professionals, substance use disorders are not perceived as a significant problem for patients receiving inpatient palliative care. However, we found that most PCUs do not screen their patients for substance misuse, suggesting that most practitioners may not have a comprehensive view of the actual number of dependent patients. Further research is therefore needed to obtain reliable data on the number of patients with substance use disorders in palliative care and to determine the point at which substance misuse is caused by medical prescription.https://doi.org/10.1186/s13722-025-00560-3Substance misusePalliative careAddictionPotential riskSubstance use disorder
spellingShingle Jannis Eersink
Julian Maul
Nils Heuser
Astrid Morin
Martin Gschnell
Christian Volberg
Medication misuse and illicit substance use among palliative care patients in German palliative care units– an evaluation from the perspective of palliative care providers
Addiction Science & Clinical Practice
Substance misuse
Palliative care
Addiction
Potential risk
Substance use disorder
title Medication misuse and illicit substance use among palliative care patients in German palliative care units– an evaluation from the perspective of palliative care providers
title_full Medication misuse and illicit substance use among palliative care patients in German palliative care units– an evaluation from the perspective of palliative care providers
title_fullStr Medication misuse and illicit substance use among palliative care patients in German palliative care units– an evaluation from the perspective of palliative care providers
title_full_unstemmed Medication misuse and illicit substance use among palliative care patients in German palliative care units– an evaluation from the perspective of palliative care providers
title_short Medication misuse and illicit substance use among palliative care patients in German palliative care units– an evaluation from the perspective of palliative care providers
title_sort medication misuse and illicit substance use among palliative care patients in german palliative care units an evaluation from the perspective of palliative care providers
topic Substance misuse
Palliative care
Addiction
Potential risk
Substance use disorder
url https://doi.org/10.1186/s13722-025-00560-3
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