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02.04.2024 | Chronic Pain Medicine (O Viswanath, Section Editor)

Neuropsychiatric Effects Associated with Opioid-Based Management for Palliative Care Patients

verfasst von: Alan D. Kaye, Kylie Dufrene, Jada Cooley, Madeline Walker, Shivam Shah, Alex Hollander, Sahar Shekoohi, Christopher L. Robinson

Erschienen in: Current Pain and Headache Reports

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Abstract

Purpose of Review

The abundance of opioids administered in the palliative care setting that was once considered a standard of care is at present necessitating that providers evaluate patients for unintentional and deleterious symptomology related to aberrant opioid use and addiction. Polypharmacy with opioids is dynamic in affecting patients neurologically, and increased amounts of prescriptions have had inimical effects, not only for the individual, but also for their families and healthcare providers. The purpose of this review is to widen the perspective of opioid consequences and bring awareness to the numerous neuropsychiatric effects associated with the most commonly prescribed opioids for patients receiving palliative care.

Recent Findings

Numerous clinical and research studies have found evidence in support for increased incidence of opioid usage and abuse as well as undesirable neurological outcomes. The most common and concerning effects of opioid usage in this setting are delirium and problematic drug-related behavioral changes such as deceitful behavior towards family and physicians, anger outbursts, overtaking of medications, and early prescription refill requests. Other neuropsychiatric effects detailed by recent studies include drug-seeking behavior, tolerance, dependence, addictive disorder, anxiety, substance use disorder, emotional distress, continuation of opioids to avoid opioid withdrawal syndrome, depression, and suicidal ideation.

Summary

Opioid usage has detrimental and confounding effects that have been overlooked for many years by palliative care providers and patients receiving palliative care. It is necessary, even lifesaving, to be cognizant of potential neuropsychiatric effects that opioids can have on an individual, especially for those under palliative care. By having an increased understanding and awareness of potential opioid neuropsychiatric effects, patient quality of life can be improved, healthcare system costs can be decreased, and patient outcomes can be met and exceeded.

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Titel: Neuropsychiatric Effects Associated with Opioid-Based Management for Palliative Care Patients
verfasst von: Alan D. Kaye
Kylie Dufrene
Jada Cooley
Madeline Walker
Shivam Shah
Alex Hollander
Sahar Shekoohi
Christopher L. Robinson
Publikationsdatum: 02.04.2024
Verlag: Springer US
Erschienen in: Current Pain and Headache Reports
Print ISSN: 1531-3433
Elektronische ISSN: 1534-3081
DOI: https://doi.org/10.1007/s11916-024-01248-0

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Springer Medizin

Neuropsychiatric Effects Associated with Opioid-Based Management for Palliative Care Patients

Abstract

Purpose of Review

Recent Findings

Summary

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Akuter Schwindel: Wann lohnt sich eine MRT?

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

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Ärztliche Empathie hilft gegen Rückenschmerzen

Update AINS

Springer Medizin

Abstract

Purpose of Review

Recent Findings

Summary

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Neu im Fachgebiet AINS

Akuter Schwindel: Wann lohnt sich eine MRT?

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Hinter dieser Appendizitis steckte ein Erreger

Ärztliche Empathie hilft gegen Rückenschmerzen

Update AINS