Question

How does alcohol withdraw treatment in hospital applies to hospice and holistic care

Answer 1

Ans) People who use alcohol and other drugs and who are over the age of 40 are now more likely to die of a non‐drug related cause than people who use substances under the age of 40. This population will therefore potentially need greater access to palliative and end of life care services.

- Initially, the purpose of this rapid evidence assessment (REA) base in relation to end of life care for people with problematic substance use. The following databases were searched using date parameters.

- Given the dearth of evidence emerging on interventions and practice responses to problematic substance use, the inclusion criteria were broadened to include any peer‐reviewed literature focussing on substance use specifically and end of life care.

- Thematic approach to categorise findings, papers fell into three broad groups (a) pain management, (b) homeless and marginalised groups, and (c) alcohol‐related papers. In general, this small and diverse literature lacked depth and quality. There are challenges for health and social care professionals in meeting the end of life needs of people who use substances. Addressing issues like safe prescribing for pain management becomes more challenging in the presence of substance use and requires flexible service provision from both alcohol/drug services and end of life care providers. Work is needed to develop models of good practice in working with co‐existing substance use and end of life conditions as well as prevalence studies to provide a wider context for policy development.

- There is an increase in older substance users who will require end of life care.
Meeting end of life needs for this group of people will require flexible service provision.
Problematic substance users often present with complex social and medical problems that make accessing formalised end of life care services more difficult to navigate than other populations.