{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:00:06Z","timestamp":1787882406846,"version":"build-2784847793"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T00:00:00Z","timestamp":1671667200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1478951522001717_sec1a\"><jats:title>Background<\/jats:title><jats:p>Nonmedical opioid use (NMOU) has been associated with opioid overdose deaths. This pattern of misuse can be seen in those using opioids for cancer-associated pain. We present a case that highlights the complexities associated with NMOU and a patient\u2019s care at the end of life.<\/jats:p><\/jats:sec><jats:sec id=\"S1478951522001717_sec2b\"><jats:title>Cases Description<\/jats:title><jats:p>A patient with a metastatic solid tumor malignancy along with co-occurring history of polysubstance abuse was admitted to an acute palliative and supportive care unit (APSCU). The patient demonstrated behaviors concerning for NMOU during her hospital stay but had increased symptom expression concerning for worsening dyspnea while in the APSCU. Unfortunately, she used home opioids, which was unknown to the team at the time along with requesting for higher doses of opioids that were being prescribed. This caused a worsening respiratory status and affected her care. Using an interdisciplinary approach, the providers managed her symptoms and discharged her safely to see her child.<\/jats:p><\/jats:sec><jats:sec id=\"S1478951522001717_sec3c\"><jats:title>Conclusion<\/jats:title><jats:p>This highlights the complexities of the alleviation of suffering in those with NMOU. It is important to continue to manage NMOU at the end of life due to its effects on quality of life. A multimodal approach is recommended to identify and care for these patients.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1478951522001717","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T08:08:40Z","timestamp":1671696520000},"page":"561-563","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Nonmedical opioid use at the end of life: A tale of addiction and a last wish"],"prefix":"10.1017","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1936-6136","authenticated-orcid":false,"given":"Michael","family":"Tang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Arthur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Bruera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,12,22]]},"reference":[{"key":"S1478951522001717_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2021.01.005"},{"key":"S1478951522001717_ref5","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33326"},{"key":"S1478951522001717_ref6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.370"},{"key":"S1478951522001717_ref13","doi-asserted-by":"publisher","DOI":"10.1177\/1049909118806664"},{"key":"S1478951522001717_ref14","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.52.2508"},{"key":"S1478951522001717_ref20","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2020.0537"},{"key":"S1478951522001717_ref4","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2017-0248"},{"key":"S1478951522001717_ref21","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14081884"},{"key":"S1478951522001717_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.08.031"},{"key":"S1478951522001717_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70040-2"},{"key":"S1478951522001717_ref22","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.6789"},{"key":"S1478951522001717_ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s40140-020-00419-0"},{"key":"S1478951522001717_ref10","first-page":"71","article-title":"Identifying and assessing the risk of opioid abuse in patients with cancer: An integrative review","volume":"7","author":"Carmichael","year":"2016","journal-title":"Substance Abuse and Rehabilitation"},{"key":"S1478951522001717_ref17","unstructured":"U.S. Department of Health and Human Services (2021) Opioid crisis statistics. https:\/\/www.hhs.gov\/opioids\/about-the-epidemic\/opioid-crisis-statistics\/index.html (accessed 14\u00a0November\u00a02022 )."},{"key":"S1478951522001717_ref12","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_100020"},{"key":"S1478951522001717_ref7","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.15432"},{"key":"S1478951522001717_ref8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.20388"},{"key":"S1478951522001717_ref16","first-page":"1","volume-title":"The CBHSQ Report","author":"Lipari","year":"2013"},{"key":"S1478951522001717_ref3","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-018-0143-7"},{"key":"S1478951522001717_ref15","doi-asserted-by":"publisher","DOI":"10.3109\/15360280903583123"},{"key":"S1478951522001717_ref19","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2019-0242"},{"key":"S1478951522001717_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(00)00109-3"}],"container-title":["Palliative and Supportive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1478951522001717","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T03:16:17Z","timestamp":1683688577000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1478951522001717\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,22]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["S1478951522001717"],"URL":"https:\/\/doi.org\/10.1017\/s1478951522001717","relation":{},"ISSN":["1478-9515","1478-9523"],"issn-type":[{"value":"1478-9515","type":"print"},{"value":"1478-9523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,22]]},"assertion":[{"value":"\u00a9 The Author(s), 2022. 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