Opioid risk assessment in palliative medicine

Area of Science:

• Palliative Medicine
• Pain Management
• Pharmacology

Background:

• Opioid therapy is a cornerstone of palliative medicine for severe pain management.
• Emerging risks associated with chronic opioid use necessitate a re-evaluation in palliative care settings.

Purpose of the Study:

• To review and present information on the risks associated with opioid therapy in palliative care.
• To highlight the importance of risk assessment and management for patients receiving chronic opioid treatment.

Main Methods:

• Literature search of PubMed and Web of Science using keywords 'palliative care' and 'opioid risk'.
• Utilized Medical Subject Headings including 'Analgesics, Opioid', 'Pain/drug therapy,' 'Palliative Care', and 'Hospice Care'.
• Cross-referencing within identified literature and library assistance were employed to identify further sources.

Main Results:

• Key opioid-related risks discussed include sedation, cognitive impairment, falls, constipation, addiction, aberrant behavior, and respiratory depression leading to death.
• Increased opioid doses can exacerbate adverse effects, potentially limiting therapeutic benefits.

Conclusions:

• Chronic opioid therapy is widely accepted for severe end-of-life pain palliation.
• Careful patient screening and ongoing follow-up are vital for identifying and managing risk factors.
• Adjunctive pain treatments can reduce opioid dosage and improve patient outcomes.