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Related Experiment Videos

Trust violated: analgesics for addicts.

Richard T Penson1, Catherine Nunn, Jerry Younger

  • 1Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114-2617, USA. rpenson@partners.org

The Oncologist
|April 17, 2003
PubMed
Summary

This case study highlights managing addiction in cancer patients on strong analgesics. Rebuilding trust through collaboration with substance abuse clinics is key for effective patient care.

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Area of Science:

  • Oncology
  • Palliative Care
  • Addiction Medicine

Background:

  • The Kenneth B. Schwartz Center at Massachusetts General Hospital (MGH) supports compassionate healthcare delivery.
  • Addiction in cancer patients receiving strong analgesics presents a complex clinical challenge.
  • Multidisciplinary forums like Schwartz Center Rounds address psychosocial issues in patient care.

Observation:

  • A case of a 28-year-old woman with breast cancer and bone metastases addicted to Percocet (oxycodone and acetaminophen) is presented.
  • The patient experienced dysfunctional social chaos and had broken trust with her healthcare team.
  • Management involved rebuilding trust through a contractual agreement and incorporating a substance abuse clinic.

Findings:

  • Open and honest support enabled the healthcare team to care for and empower the patient.

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  • Successful management required addressing issues of trust, liability, and opioid tolerance.
  • Barriers to optimal analgesia for cancer pain were navigated through collaborative care.

    • Implications:

    • This case underscores the importance of integrated care models for managing complex patient needs.
    • Effective strategies for rebuilding trust are crucial in treating patients with substance use disorders.
    • Addressing addiction in cancer patients is vital for improving pain management and overall quality of life.