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P-103 Illicit drug use – How to manage in a hospice setting
  1. Wendy Ashton and
  2. Sarah Stevenson
  1. Eden Valley Hospice and Jigsaw Children’s Hospice, Carlisle, UK


Background ‘Bill’ was in his early 40s. Admitted from home to the hospice for symptom assessment and end of life care. A former IV drug user on a methadone programme with support from the Drugs and Alcohol Team. His partner was also known to be on a methadone programme. Bill had advanced metastatic cancer. After the discovery of un-prescribed pills, Bill confirmed that he had been taking a number of ‘street’ tablets a day. Drug paraphernalia was discovered in the hospice grounds. Bill admitted to taking heroin when out for a smoke. Now imminently approaching end of life.


  • To develop a policy and guidance for illicit drug use in the hospice.

  • To assess on admission if non-prescribed drugs are being used.

  • To reassure staff that practice was good and look at improving knowledge, confidence and staff awareness.

  • To collaborate with external agencies.


  • Staff debrief, peer supervision and training opportunities (Galvani, 2012).

  • Meetings for advice with Controlled Drugs Local Intelligence Network.

  • MDT meeting re: admission paperwork and development of a policy.

  • Link with Drugs and Alcohol team to build contacts for future work (Alcohol Change UK, 2019; Reith & Payne, 2019).

  • Collaboration with: GP, Recovery Steps, Oncology, Police, Safeguarding, family (Alcohol Change UK, 2019; Reith & Payne, 2019).

Results The hospice now has an illicit drug use policy and guidance. Developed a relationship with the Controlled Drugs Local Intelligence Network and Drugs and Alcohol Team and shared our experience with other organisations for learning. Staff debrief led to training opportunities and more confident staff. Addition of generic questions on admission to ascertain if any non-prescribed medication being used (alcohol, homeopathic agents, illicit drugs).

Conclusion We continue to offer holistic care with a more robust admission assessment and a better awareness of addiction and drug use. We respect the rights of service users whilst protecting them from, as far as possible danger/harm (Galvani, 2012).

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