Assessment and support of people experiencing problematic substance use at the end of life

There is limited evidence relating to end of life care for people with a history of problematic substance use, despite a growing need for treatment related to an older opiate-using population and increased premature mortality associated with alcohol-related liver disease. This article examines several significant challenges for nurses in supporting people who have engaged in problematic substance use, often resulting in comorbidities such as kidney damage, respiratory conditions and/or chronic pain. These challenges include ensuring accurate assessment and screening and how to openly communicate with individuals to explore their problematic substance use. The author also discusses advance care planning at the end of life and the challenges of providing effective palliative care and pain management for this population.