{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:37:27Z","timestamp":1790678247037,"version":"4.1.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Filling the Gap grant for personal protected time to CH","award":["none"],"award-info":[{"award-number":["none"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Palliat Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Access to palliative care is often limited for challenging and vulnerable groups, including persons with substance use disorders. However, with optimized healthcare options and liberal substitution policies, this patient group is likely to increase over the upcoming years, and comorbidities will also influence the need for palliative support. Here, we aim at analyzing characteristics and specific challenges associated with substance use disorders (SUD) in palliative care.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We retrospectively reviewed all patients diagnosed with substance use disorder that were treated at our Competence Center Palliative Care within the University Hospital Zurich, Switzerland between 2015 and 2021. Patient characteristics, including age, gender, duration of hospitalization, as well as specific metrics like body mass index, distinct palliative care assessment scores, and in-hospital opioid consumption were retrieved from the electronic patient files. Demographics and clinical data were analyzed by descriptive statistics, and compared to those of a control group of palliative care patients without SUD. An opioid calculator was used to standardize opioid intake based on morphine equivalents for meaningful comparisons.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The primary characteristics revealed that the majority of individuals were single (56%), had no children (83%), lived alone (39%), and were either unemployed or recipients of a disability pension (in total 50%). Nicotine (89%), opioids (67%), and alcohol (67%) were the most used substances. We identified various comorbidities including psychiatric illnesses alongside SUD (56%), hepatitis A, B, or C (33%), and HIV infection (17%). Patients with SUD were significantly younger (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.5), predominantly male (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), and reported a higher prevalence of pain (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.5) compared to the standard cohort of palliative patients. Regarding the challenges most frequently reported by healthcare practitioners, non-compliance, multimorbidity, challenging communication, biographical trauma, lack of social support, and unstable housing situations played a key role.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Patients with SUD represent a complex and vulnerable group dealing with multiple comorbidities that profoundly affect both their physical and psychological well-being. Understanding their unique characteristics is pivotal in providing precise and suitable palliative care.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12904-024-01366-x","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T03:02:38Z","timestamp":1706583758000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Characteristics and clinical challenges in patients with substance use disorder in palliative care\u2014experience from a tertiary center in a high-income country"],"prefix":"10.1186","volume":"23","author":[{"given":"Laura","family":"Marti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"H\u00fcnerwadel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bigna","family":"Hut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian M.","family":"Christ","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"D\u00e4ster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Schettle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annina","family":"Seiler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Blum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Hertler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,30]]},"reference":[{"issue":"9904","key":"1366_CR1","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1016\/S0140-6736(13)61611-6","volume":"382","author":"HA Whiteford","year":"2013","unstructured":"Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the global burden of Disease Study 2010. Lancet. 2013;382(9904):1575\u201386.","journal-title":"Lancet"},{"issue":"9752","key":"1366_CR2","doi-asserted-by":"publisher","first-page":"1558","DOI":"10.1016\/S0140-6736(10)61462-6","volume":"376","author":"DJ Nutt","year":"2010","unstructured":"Nutt DJ, King LA, Phillips LD. Independent Scientific Committee on D. Drug harms in the UK: a multicriteria decision analysis. Lancet. 2010;376(9752):1558\u201365.","journal-title":"Lancet"},{"issue":"1","key":"1366_CR3","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1177\/1049909121999783","volume":"39","author":"KF Jones","year":"2022","unstructured":"Jones KF, Ho JJ, Sager Z, Childers J, Merlin J. Adapting Palliative Care skills to provide substance use disorder treatment to patients with serious illness. Am J Hosp Palliat Care. 2022;39(1):101\u20137.","journal-title":"Am J Hosp Palliat Care"},{"issue":"4","key":"1366_CR4","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1017\/S1478951522000591","volume":"20","author":"C Magoon","year":"2022","unstructured":"Magoon C, Shalev D. Toward holistic care: including substance use in mental health-palliative care integration. Palliat Support Care. 2022;20(4):453\u20134.","journal-title":"Palliat Support Care"},{"issue":"3\u20134","key":"1366_CR5","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1177\/0825859717738445","volume":"32","author":"A MacCormac","year":"2017","unstructured":"MacCormac A. Alcohol dependence in Palliative Care: a review of the current literature. J Palliat Care. 2017;32(3\u20134):108\u201312.","journal-title":"J Palliat Care"},{"issue":"6","key":"1366_CR6","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1097\/00000421-198212000-00014","volume":"5","author":"MM Oken","year":"1982","unstructured":"Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5(6):649\u201355.","journal-title":"Am J Clin Oncol"},{"issue":"3","key":"1366_CR7","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/S0261-5614(02)00214-5","volume":"22","author":"J Kondrup","year":"2003","unstructured":"Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, Ad Hoc EWG. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321\u201336.","journal-title":"Clin Nutr"},{"issue":"4","key":"1366_CR8","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1111\/j.1530-7085.2003.03034.x","volume":"3","author":"CT Hartrick","year":"2003","unstructured":"Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract. 2003;3(4):310\u20136.","journal-title":"Pain Pract"},{"issue":"2","key":"1366_CR9","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1024\/0040-5930\/a000256","volume":"69","author":"S Eychmuller","year":"2012","unstructured":"Eychmuller S. [SENS is making sense - on the way to an innovative approach to structure Palliative Care problems]. Ther Umsch. 2012;69(2):87\u201390.","journal-title":"Ther Umsch"},{"issue":"4","key":"1366_CR10","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1177\/082585971503100404","volume":"31","author":"AR Knowlton","year":"2015","unstructured":"Knowlton AR, Nguyen TQ, Robinson AC, Harrell PT, Mitchell MM. Pain symptoms Associated with Opioid Use among vulnerable persons with HIV: an exploratory study with implications for palliative care and opioid abuse prevention. J Palliat Care. 2015;31(4):228\u201333.","journal-title":"J Palliat Care"},{"issue":"3","key":"1366_CR11","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s00482-019-0376-0","volume":"33","author":"H Hoffmann-Menzel","year":"2019","unstructured":"Hoffmann-Menzel H, Goldmann J, Kern M, Weckbecker K, Wullenweber L, Radbruch L. [Palliative care of patients receiving opioid substitution therapy]. Schmerz. 2019;33(3):263\u201380.","journal-title":"Schmerz"},{"issue":"4","key":"1366_CR12","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1097\/YCO.0000000000000718","volume":"34","author":"M Cabanis","year":"2021","unstructured":"Cabanis M, Outadi A, Choi F. Early childhood trauma, substance use and complex concurrent disorders among adolescents. Curr Opin Psychiatry. 2021;34(4):393\u20139.","journal-title":"Curr Opin Psychiatry"},{"issue":"4","key":"1366_CR13","first-page":"313","volume":"47","author":"M Pompili","year":"2012","unstructured":"Pompili M, Innamorati M, Lester D, Serafini G, Erbuto D, Battuello M, et al. Suicide attempts in acute psychiatric referrals with substance use disorders. Riv Psichiatr. 2012;47(4):313\u20138.","journal-title":"Riv Psichiatr"},{"issue":"10","key":"1366_CR14","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1007\/s40263-019-00660-0","volume":"33","author":"S Mercadante","year":"2019","unstructured":"Mercadante S, Arcuri E, Santoni A. Opioid-Induced Tolerance and Hyperalgesia. CNS Drugs. 2019;33(10):943\u201355.","journal-title":"CNS Drugs"},{"issue":"8","key":"1366_CR15","doi-asserted-by":"publisher","first-page":"819","DOI":"10.23736\/S0375-9393.19.13767-4","volume":"85","author":"S Natoli","year":"2019","unstructured":"Natoli S. Opioid use in addiction: swinging between pain under-treatment and opioids harms. Minerva Anestesiol. 2019;85(8):819\u201321.","journal-title":"Minerva Anestesiol"},{"issue":"s2","key":"1366_CR16","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1080\/10550490390210218","volume":"12","author":"SH Schnoll","year":"2003","unstructured":"Schnoll SH, Weaver MF. Addiction and pain. Am J Addict. 2003;12(s2):27\u2013S35.","journal-title":"Am J Addict"},{"issue":"1","key":"1366_CR17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/j.pain.0000000000003024","volume":"165","author":"JC Ballantyne","year":"2024","unstructured":"Ballantyne JC. Preventing a prescription opioid epidemic in Switzerland. Pain. 2024;165(1):1\u20132.","journal-title":"Pain"},{"issue":"1","key":"1366_CR18","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1097\/AJP.0000000000001000","volume":"38","author":"MD Sullivan","year":"2021","unstructured":"Sullivan MD, Ballantyne JC. The right to Pain Relief: its origins in End-of-life Care and Extension to Chronic Pain Care. Clin J Pain. 2021;38(1):58\u201363.","journal-title":"Clin J Pain"},{"issue":"1","key":"1366_CR19","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/s12904-022-01017-z","volume":"21","author":"V Dos Santos Barros","year":"2022","unstructured":"Dos Santos Barros V, Bassi-Dibai D, Guedes CLR, Morais DN, Coutinho SM, de Oliveira Simoes G, et al. Barthel Index is a valid and reliable tool to measure the functional independence of cancer patients in palliative care. BMC Palliat Care. 2022;21(1):124.","journal-title":"BMC Palliat Care"},{"issue":"5","key":"1366_CR20","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1007\/s11920-012-0298-3","volume":"14","author":"D Krashin","year":"2012","unstructured":"Krashin D, Murinova N, Ballantyne J. Management of pain with comorbid substance abuse. Curr Psychiatry Rep. 2012;14(5):462\u20138.","journal-title":"Curr Psychiatry Rep"},{"issue":"1","key":"1366_CR21","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s12904-019-0502-x","volume":"19","author":"A Ebenau","year":"2020","unstructured":"Ebenau A, Dijkstra B, Ter Huurne C, Hasselaar J, Vissers K, Groot M. Palliative care for patients with substance use disorder and multiple problems: a qualitative study on experiences of healthcare professionals, volunteers and experts-by-experience. BMC Palliat Care. 2020;19(1):8.","journal-title":"BMC Palliat Care"},{"key":"1366_CR22","doi-asserted-by":"publisher","first-page":"111036","DOI":"10.1016\/j.drugalcdep.2023.111036","volume":"254","author":"T Schwarz","year":"2024","unstructured":"Schwarz T, Anzenberger J, Busch M, Gmel G, Kraus L, Krausz M, et al. Opioid agonist treatment in transition: a cross-country comparison between Austria, Germany and Switzerland. Drug Alcohol Depend. 2024;254:111036.","journal-title":"Drug Alcohol Depend"},{"issue":"4","key":"1366_CR23","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1159\/000500542","volume":"25","author":"S Gastberger","year":"2019","unstructured":"Gastberger S, Baumgartner MR, Soyka M, Quednow BB, Hulka LM, Herdener M, et al. Concomitant heroin and Cocaine Use among opioid-dependent patients during Methadone, Buprenorphine or Morphine Opioid Agonist Therapy. Eur Addict Res. 2019;25(4):207\u201312.","journal-title":"Eur Addict Res"}],"container-title":["BMC Palliative Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12904-024-01366-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12904-024-01366-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12904-024-01366-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T14:03:00Z","timestamp":1706623380000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpalliatcare.biomedcentral.com\/articles\/10.1186\/s12904-024-01366-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,30]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1366"],"URL":"https:\/\/doi.org\/10.1186\/s12904-024-01366-x","relation":{},"ISSN":["1472-684X"],"issn-type":[{"value":"1472-684X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,30]]},"assertion":[{"value":"31 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 January 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki and applicable regulatory requirements and has been approved by the institution and the local ethics committee \u201cKantonale Ethikkommission Zurich\u201d (KEK-ZH-Nr. 2019\u201302488). All included patients gave <i>informed consent<\/i> to data use according to the institutional procedures, allowing for retrospective data analysis within the fully approved ethics proposal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"None.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}],"article-number":"28"}}