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Pain Management in Advanced Illness and Comorbid Substance Use Disorder

Walsh, Anne F. MSN, ANP-BC, ACHPN, CWOCN; Broglio, Kathleen MN, ANP-BC, ACHPN, CPE

Journal of Hospice & Palliative Nursing: January-February 2010 - Volume 12 - Issue 1 - p 8-14
doi: 10.1097/NJH.0b013e3181c72e19
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Pain is a common, feared, and often undertreated symptom faced by people with life-limiting illnesses. Those with substance use disorder are at an even greater risk of inadequate pain management. Much of the literature addresses those with chronic nonmalignant pain, with limited literature focusing on those with advanced illness, pain, and comorbid addictive disease. The purpose of this article was to provide assessment and treatment strategies for safe pain management in this population. This article highlights a case study of a patient with advanced illness, pain, and comorbid substance use disorder who was seen by the palliative care consultation team in the home care setting.

Author Affiliations: Anne F. Walsh, MSN, ANP-BC, ACHPN, CWOCN, is Nurse Practitioner, Palliative Care Consultation Team, Metropolitan Jewish Health System, Brooklyn, NY.

Kathleen Broglio, MN, ANP-BC, ACHPN, CPE, is Nurse Practitioner, Pain Management, Bellevue Hospital Center, New York, NY.

Address correspondence to Anne F. Walsh, MSN, ANP-BC, ACHPN, CWOCN, Palliative Care Consultation Team, Metropolitan Jewish Health System, 6323 Seventh Ave, Third Floor, Brooklyn, NY 11220 (anwalsh@mjhs.org).

© 2010 The Hospice and Palliative Nurses Association