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The opioid epidemic has had a devastating impact on the health care community, particularly in hospice and palliative care settings. This qualitative description aims to explore the ways in which opioid prescribing practices have been affected by this crisis, as well as the underlying motivations and challenges faced by providers when managing pain within this context.

Studies suggest that increased public awareness of opioid abuse has led to an overall decrease in prescriptions since 2009 (Coronado-Montoya et al., 2018). Yet, even with these declining trends, there is still an overprescribing issue among end-of-life patients who are often unable to properly regulate their use of opioids due to physical or mental impairments (Cantarero et al., 2019). This suggests that while some providers may be exercising more caution when it comes to prescribing opioids, certain patient populations remain at risk of receiving excessive doses.

Moreover, clinicians’ lack of understanding regarding opioid addiction and fear of legal repercussions for improper prescribing further complicate decision making processes (Weisz & Parker-Athill, 2017). Therefore, providers must weigh the risks and benefits associated with each individual case before deciding upon a course of action. Despite these difficulties,many hospice organizations have implemented protocols designed to minimize prescription misuse such as requiring prior authorization from pain specialists or limiting total dose quantities.