{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:10:32Z","timestamp":1787019032802,"version":"build-2736575974"},"reference-count":65,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2018,10,23]],"date-time":"2018-10-23T00:00:00Z","timestamp":1540252800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>The current opioid crisis in the United States is a major problem facing health-care providers, even at the end of life. Opioids continue to be the mainstay treatment for pain at the end of life, with the prevalence of pain reported in up to 80% of patients and tends to increase as one gets closer toward the end of life. In the past year, 20.2 million Americans had a substance use disorder (SUD) and SUDs are disabling disorders that largely go untreated. In addition, the coexistence of both a mental health and SUD is very common with the use of opioids often as a means of chemical coping. Most hospice programs do not have standardized SUD policies\/guidelines in place despite the increasing concerns about substance abuse within the United States. The goal of this article is to review the literature on this topic and offer strategies on how to manage pain in patients who have active SUD or who are at risk for developing SUD in those dying on hospice.<\/jats:p>","DOI":"10.1177\/1049909118806664","type":"journal-article","created":{"date-parts":[[2018,10,23]],"date-time":"2018-10-23T23:09:54Z","timestamp":1540336194000},"page":"273-281","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Dying on Hospice in the Midst of an Opioid Crisis: What Should We Do Now?"],"prefix":"10.1177","volume":"36","author":[{"given":"Jennifer","family":"Gabbard","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Internal Medicine Section of Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Jordan","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Christian and Alton Memorial Hospitals, BJC Hospice, Washington University School of Medicine, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hospital Medicine, Emory Palliative Care Center, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Corbett","sequence":"additional","affiliation":[{"name":"Trellis Supportive Care, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"White","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, BJC Home Care, Washington University School of Medicine, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Childers","sequence":"additional","affiliation":[{"name":"Section of Palliative Care and Medical Ethics and Section of Treatment, Research and Education in Addiction Medicine, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,10,23]]},"reference":[{"issue":"50","key":"bibr1-1049909118806664","first-page":"1378","volume-title":"MMWR Morb Mort Wkly Rep","volume":"64","author":"Rudd RA","year":"2016"},{"key":"bibr2-1049909118806664","unstructured":"Centers for Disease Control and Prevention. 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