Top Ten Tips Palliative Care Clinicians Should Know when Caring for Seriously Ill Patients with Stimulant Use Disorders

Stimulant use disorder (StUD) is common in the hospice and palliative care (PC) setting, though guidance for clinicians remains limited. Stigma around stimulant use is widespread and can lead to impaired clinician/patient communication, poor symptom control, and lower quality of care. PC clinicians should be able to diagnose StUD, understand the potential pharmacologic and nonpharmacologic management options, engage with patients in a trauma-informed way, and refer to addiction medicine colleagues when appropriate. When utilizing opioids for pain management, PC clinicians should be aware of the impact of stimulant use on opioid risk and toxicity. In this article, a multidisciplinary group of PC, hospice, addiction medicine, psychiatry, ethics, and pharmacy clinicians presents ten practical tips for caring for seriously ill patients with current or prior StUD.