Bloomberg News recently reported on a man named Charles Groomes who became addicted to OxyContin while living at home under hospice care following a diagnosis of terminal cancer.  Despite a history of substance abuse, what began as a daily dose of about 200 milligrams of OxyContin and oxycodone was steadily increased over the period of a year to 2880 milligrams.  It turned out that Groomes didn’t have cancer and was released from hospice 32 months later – depressed, addicted and with a possible heart condition brought on by inactivity.  In less than two years he died in his sleep at age 52; his family suspect that he overdosed on OxyContin.

Later Stages of Life Present Unique Challenges

Dr. Aaron Smuckler treated Groomes following his release from hospice.  He stated that Groomes clearly wasn’t dying and described the situation as “a hospice case that spiraled out of control.”  Unfortunately, this case is not completely unique.  Lax admission policies and the liberal use of narcotic drugs add up to many patients who are not dying becoming addicted to painkiller medication while in hospice care.

Walter Ling, director of UCLA’s substance abuse program, says that hospice cases like Charles Groomes’s are familiar to everyone who works in drug treatment.  Hospice physicians regularly prescribe narcotic painkillers to patients who aren’t experiencing extreme pain.  Although hospice is only supposed to be prescribed for patients who have been diagnosed with less than 6 months to live, there are reports that some providers increase revenues by admitting patients who don’t need hospice care. Patients are then over-medicated and neglected.  Groomes’s family says that he saw a doctor only about 5 times during the entire 3 years that he was in hospice.

There are currently more than 1 million people in hospice care in the U.S.  According to Medicare records, about 21% of these patients will stay in hospice longer than 6 months.  About 200,000 are well enough to be discharged from hospice each year.

A Harvard University study has found that for-profit hospices have a live discharge rate of about 20%, while the discharged rate for nonprofit hospices is about 12%.  Patients in for-profit hospice programs stay for 98 days on average; the average stay in nonprofit hospices is 68 days.  Harvard professor Nancy Kane has stated that long stays and high discharge rates suggest that some hospices are signing up people who don’t belong there. The result is people who are released from hospice with drug addiction problems that will decrease their quality of life for years to come.