Addressing the physical, psychological, social, and spiritual needs of dying patients includes management of their pain. But how have increasing concerns and policies that target opioid misuse impacted their pain management options?
The American Medical Association (AMA) Ed Hub hosted a webinar with Dr. Chad Kollas and Dr. Bobby Mukkamala, who shared an in-depth analysis of the current landscape of opioid prescribing practices. Dr. Kollas has served as the medical director for Palliative and Supportive Medicine at the Orlando Cancer Institute in Orlando, Florida for over 20 years. Dr. Mukkamala is a board certified otolaryngologist, head and neck surgeon, and a member of the American Medical Association’s Board of Trustees.
Dr. Kollas begins by discussing the critical role of opioids in managing severe pain for patients with life-limiting conditions, stressing that effective pain relief is a fundamental goal of palliative care. He emphasizes the balance that healthcare providers must achieve ensuring adequate pain control and complying with regulatory measures designed to prevent opioid misuse and addiction; the intersection of addiction and chronic pain.
A significant portion of the discussion is dedicated to the impact of constricted opioid regulations on hospice and palliative care. Experts note that while these regulations aim to curb the opioid crisis, they often lead to unintended consequences, such as under-treatment of pain in seriously ill patients. Long-term opioid therapy can be safe for many patients with right prescribing and monitoring. Maintaining a patient-centered approach is important; ensuring that fear of regulatory repercussions does not prevent healthcare professionals from prescribing necessary pain medications.
Dr. Kollas provides several examples of patients and his approach for individualized, optimal care. It is important to communicate and offer care that manages symptoms, like pain and other distress, in a way that helps them reach their personal and unique quality of life goals.
Strategies to navigate these challenges include advocating for enhanced education and training for healthcare providers on safe and effective opioid use as well as implementing comprehensive pain management programs that include both pharmacologic and non-pharmacologic interventions.
The goal is to ensure that patients in hospice and palliative care receive compassionate care that helps their pain and other symptoms. The key is compassionate pain care has to be individualized.
