Managing Opioid Use Disorder in the Setting of a Terminal Disease: Opportunities and Challenges

J Palliat Med. 2020 Feb;23(2):296-299. doi: 10.1089/jpm.2019.0101. Epub 2019 Jul 11.


Opioids have long been a mainstay of symptom management in palliative care (PC), allowing patients with terminal illnesses to have an improved quality of life. Unfortunately, these same medications have contributed to the explosion of the opioid epidemic. This article explores the case of a patient with opioid use disorder (OUD) and pancreatic cancer. We share our experience of managing his symptoms and treating OUD in the setting of an outpatient PC clinic. We explore the challenges and joys of this case while reflecting on the need for more research investigating best practices for individuals where opioids serve as both a pain reliever and contributor to further suffering from their OUD.

Keywords: opioid misuse; opioid use disorder; pain; palliative care; substance use disorders.

Publication types

  • Case Reports

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Hospice and Palliative Care Nursing*
  • Humans
  • Opioid-Related Disorders* / drug therapy
  • Palliative Care
  • Quality of Life


  • Analgesics, Opioid