Opioid use at home is safe for patients who need pain relief

Increased doses of opioids during end-of-life care at home is safe to relieve pain and suffering, according to a study published in the Journal of Palliative Medicine (2010 Sep;13(9):1079-83).

According to background information provided in the press release announcing the findings, many physicians around the world are afraid to prescribe opioids in sufficient doses to be effective in terminally ill patients in the home setting.

Itxaso Bengoechea, MD and colleagues from Galdakao-Usánsolo Hospital in Bizkaia, Spain, conducted a study on the safety and survival effects of increasing doses of opioids during end-of-life care at home. Included in the study were 223 patients with terminal cancer who received specialized medical and nursing care as well as active monitoring in their homes.

Researchers discovered that patients who choose to spend their last days at home with specialized care and monitoring can safely be given opioids to control pain and other symptoms without reducing survival time. Specifically, the authors reported that patients who received a grater than two-fold increase in their initial dose had a longer median survival (22 days) than those who received lower doses (9 days).

“Many worry that use of opioids in end-of-life care tacitly hastens death,” said Charles von Gunten, MD, PhD, editor-in-chief of the Journal of Palliative Medicine and Provost, Institute for Palliative Medicine at San Diego Hospice.

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