Palliative Care for People who use Substances During Communicable Disease Epidemics and Pandemics: A Scoping Review

The COVID-19 pandemic and its response efforts magnify the health care challenges encountered by people who use substances. People who use substances are at high risk of life-limiting illnesses such as end-stage organ failure and cancer. Unfortunately, people who use substances encounter barriers to receiving palliative care. People who use substances often have few social supports and lack financial resources. Moreover, delivery of community-based health services may be restricted due to institution and provider concerns that the settings are risky or unsafe. Zero-tolerance policies toward non-medical use of substances also restrict access to palliative care units and hospices. Given these pre-existing inequities to palliative care access and increased demand for palliative care during the COVID-19 pandemic, it is important to understand the impact of COVID-19 on people with life-limiting illnesses who use substances. To address this critical issue, we propose a scoping review that will identify knowledge strengths and gaps about palliative care for people with life-limiting illnesses who use substances during communicable disease epidemics and pandemics. Our project will critically assess the state of knowledge and provide decision support for healthcare providers and policy makers during COVID-19 and future communicable disease epidemics and pandemics. Through our dedicated knowledge translation strategy, we will ensure timely dissemination of our findings to patients, caregivers, healthcare providers, and decision makers. Our project is aligned with a key goal in the Government of Canada's five-year action plan for palliative care (2019 - 2024), which seeks to to improve access to palliative care for underserved populations who experience difficulties in obtaining health care and to improve the quality of care when it is received.