Alcohol and Substance Use among Patients in Palliative Care

Abstract

There has been a growing concern about alcohol and substance use and abuse as well as abuse of prescription drugs among patients in hospice and palliative care. Literature reveals that it is likely that similar risk factors for substance abuse in persons in the general public may also exist among the terminally ill. Substance abuse among such patients could interfere with effective pain and symptom management regimes that are employed in palliative care. Numerous studies have been conducted on prevalence of substance abuse in the general public as well as special populations such as persons with disability. However, very little has been documented regarding drug use and abuse in persons with advanced chronic conditions such as patients in palliative care settings. Prevalence of alcoholism and other substances among patients in palliative care has scarcely been reported in Kenya. This study adopted a descriptive survey targeting patients with advanced cancer in an outpatient palliative care setting. Questionnaires and interviews were used to establish the prevalence of drug use among patients, the main drugs of abuse as well as risk factors for drug abuse in these patients. Purposive sampling was used to obtain a total of 50 patients within an outpatient palliative care facility. The results indicated that alcohol and tobacco were the most abused substances among patients. Those who abused tobacco either smoked or used chewing as a mode of administration. A few respondents used other substances such as artane while others chewed betel. The study recommended use of rigorous assessment to identify patients with previous or current history of substance abuse in order to employ suitable interventions. Addressing substance abuse in these settings could allow the accomplishment of appropriate palliative care services as well as maintenance of self-dignity and enhancement of quality of life for the patients and their significant others.