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Drug dependence epidemiology in palliative care medicinal cannabis trials
  1. Chee Yen Lee1,2,
  2. Phillip Good3,4,5,
  3. Georgie Huggett5,
  4. Ristan Greer3 and
  5. Janet Hardy4
  1. 1Palliative Medicine, Ipswich Hospital, Ipswich, Queensland, Australia
  2. 2Palliative Medicine, Mater Misericordiae Ltd Brisbane, South Brisbane, Queensland, Australia
  3. 3UQ, Saint Lucia, Queensland, Australia
  4. 4Supportive and Palliative Care, Mater Health Services, Brisbane, Queensland, Australia
  5. 5Mater Research Institute The University of Queensland, South Brisbane, Queensland, Australia
  1. Correspondence to Dr Chee Yen Lee, Palliative Medicine, Ipswich Hospital, Ipswich, Queensland, Australia; chee.lee{at}


Objectives Drug dependence is becoming increasingly common and meeting palliative care patients with substance use disorders is inevitable. However, data on substance use in these patients are lacking. This study aims to evaluate the prevalence of drug dependence in palliative care patients with advanced cancer and correlate with symptom distress and opioid use.

Methods Palliative care patients with advanced cancer interested in participation in a medicinal cannabis trial were required to complete Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Edmonton Symptom Assessment Scale (ESAS) and record of concomitant medications including baseline opioid use as part of the eligibility screen.

Results Of the 182 participants, 167 (92%) reported lifetime alcohol and 132/182 (73%) lifetime tobacco use. No participant reached the threshold criteria for high risk of drug dependence with majority being low risk. There was no correlation between ASSIST score, ESAS and oral morphine equivalent.

Conclusion This study identified alcohol and tobacco as the main substances used in this group of patients and that most were of very low risk for drug dependence. This suggests routine drug screening for palliative care patient may not be justified, but the high possibility of questionnaire bias is acknowledged.

  • Cancer
  • Symptoms and symptom management
  • Drug administration
  • Complementary therapy
  • Pain
  • Quality of life

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  • Contributors Conceptualisation, PG and JH; data collection, GH; analysis, CYL, RG and GH; writing and original draft preparation, CYL; writing-review editing, PG, JH and RG; supervision, project administration and funding acquisition, PG and JH. All authors have read and agreed to the submitted version of the manuscript.

  • Funding Australian National Health and Medical Research Council Medical Research Future Fund Grants (APP1152232, APP2006191) and the Mater Foundation.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.