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  1. Jason Boland
  1. Consultant in Palliative Medicine, Barnsley Hospice, United Kingdom

https://doi.org/10.1136/bmjspcare-2011-000181

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    Undocumented alcoholism and its correlation with tobacco and illegal drug use in advanced cancer patients

    ▶ Dev R, Parsons HA, Palla S, et al. Cancer 2011;117(19):4551–6.OpenUrlPubMedWeb of Science

    In this retrospective study of 665 patients, the frequency of undiagnosed alcoholism among patients with advanced cancer and its relationship to alcoholism, smoking and use of illegal drugs was assessed. The Cut Down, Annoyed, Guilty, Eye-opener (CAGE) questionnaire was completed by 598 patients. Of these, 17% had CAGE-positive results, of which only 13% had been identified before their palliative care consultation. These patients were more likely to have a current and past history of smoking, and illegal recreational drug use. Pain and dyspnoea were worse in patients who had a history of nicotine use. Both CAGE-positive patients and patients who had a history of tobacco use were more frequently receiving strong opioids at the time of their palliative care consultation.

    The use of crisis medication in the management of terminal haemorrhage due to incurable cancer: a qualitative study

    ▶ Harris D, Finlay I, Flowers S, et al. Palliat Med 2011;25(7):691–700.OpenUrlAbstract/FREE Full Text

    The practice of relieving patient distress through sedative doses of anxiolytics or opioids in terminal haemorrhage was evaluated through semi-structured interviews with 11 specialist nurses. This showed that anxiolytics and opioids rarely benefit the patient who is having a terminal haemorrhage as it is so rapid that patients died before the drugs could be administered. Furthermore, it may remove nurses from giving patient care, as staying with and supporting the patient, as well as using dark-coloured towels to camouflage blood was reported to be of more practical use. The focus on administering medications was often to the detriment of these non-pharmacological approaches.

    Unidirectional cross-activation of GRPR by MOR1D uncouples itch and analgesia induced by opioids

    ▶ Liu XY, Liu ZC, Sun YG, et al. Cell 2011;147(2):447–58.OpenUrlCrossRefPubMedWeb of Science

    Spinal opioids can cause itch, which has previously …

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Commissioned; internally peer reviewed.