# Psychiatry at the intersection of palliative care and addiction - URL: https://alisanburak.com/en/wcp-2026-posterler/so346 - Language: en - Last updated: not specified - Page title: Psychiatry at the intersection of palliative care and addiction | WCP 2026 Summary > Pharmacotherapy for opioid use disorder should be continued in advanced illness, with regimens adapted to divided dosing to maximize comfort and full mu-opioid… This page was translated automatically from Turkish. [Read the original](https://alisanburak.com/wcp-2026-posterler/so346) This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it. SO346 Brief Oral Poster PresentationConsultation-Liaison PsychiatryReview # Psychiatry at the intersection of palliative care and addiction PSYCHIATRY AT THE PALLIATIVE–ADDICTION INTERFACE Presenter: Francisca Lobo Country: Portugal Institution: ULS Loures-Odivelas, Department of Psychiatry and Mental Health Session: 3860 - PARALLEL SHORT ORAL POSTER SESSIONS: CONSULTATION LIAISON - Part III Date: Fri, 25.09.2026 Pharmacotherapy for opioid use disorder should be continued in advanced illness, with regimens adapted to divided dosing to maximize comfort and full mu-opioid agonists added when needed. The aim of this study is to synthesize current evidence and guidelines on palliative pain management in patients receiving buprenorphine, methadone, or naltrexone for opioid use disorder (OUD), and to identify optimization strategies and evidence gaps. The method is a practice-oriented narrative review of current recommendations for advanced illness and palliative care settings; tolerance, altered pain sensitivity, and barriers such as stigma, misinformation, and safety concerns complicate pain management. Buprenorphine, a high-affinity partial mu-opioid agonist, provides analgesia for approximately 6 to 8 hours, whereas withdrawal suppression lasts approximately 24 to 36 hours. Accordingly, when analgesia is the goal, the evidence supports dividing the total daily dose into doses given every 6 to 8 hours, titrating the dose in selected patients, and adding a full mu-opioid agonist at higher doses when necessary, while highlighting the risk of undertreatment driven by concerns about receptor blockade. For methadone, divided dosing two or three times daily is recommended because of its long and variable half-life and risk of accumulation. Although dose increases are possible, they are often avoided because of concerns about delayed sedation and respiratory depression; a short-acting full mu-opioid agonist is added when necessary, and QTc monitoring is guided by the goals of care. With naltrexone, a competitive mu-opioid antagonist, opioids remain largely ineffective during receptor blockade, so nonopioid multimodal analgesia (acetaminophen and NSAIDs, regional or local anesthetics, ketamine, and nonpharmacological approaches) is prioritized. Discontinuation is considered reasonable if pain is severe or refractory, with a washout period of at least 72 hours for the oral formulation and approximately 4 weeks for the injectable formulation; patients are subsequently managed as opioid-naive, with an explicit safety plan in place. Recommended practical steps are to continue OUD pharmacotherapy, divide doses, use a multimodal approach, distinguish withdrawal from delirium and anxiety, and involve psychiatry in care. The evidence base is limited: there are no prospective comparative studies, long-term outcomes and transitions between buprenorphine and methadone remain uncertain, and data on naltrexone are sparse. [View the original poster](https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/1524) How to cite this study APA 7: Lobo, F., et al. (2026, September 25). Psychiatry at the palliative–addiction interface [Poster presentation]. 26th WPA World Congress of Psychiatry (WCP 2026), Stockholm, Sweden. https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/1524 Vancouver: Lobo F, et al. Psychiatry at the palliative–addiction interface [poster]. 26th WPA World Congress of Psychiatry (WCP 2026); 2026 Sep 23-26; Stockholm, Sweden. Available from: https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/1524 Author names and title formatting were generated automatically from the congress system; please check them against the original poster before use. ## On the same topic - [Nöroonkolojide bakıma engel olarak barınma güvencesizliği: bir olgu serisi ve literatür derlemesi](https://alisanburak.com/en/wcp-2026-posterler/ev0092) - [Bipolar bozukluğun manik epizoduyla ilişkili kutanöz liken planus alevlenmesi: olgu sunumu](https://alisanburak.com/en/wcp-2026-posterler/ev0208) - [Ayrı bir psikiyatrik durum olarak zihin bulanıklığı: anlatısal derleme ve tanısal sınıflandırma için kavramsal çerçeve](https://alisanburak.com/en/wcp-2026-posterler/ev0294) - [Hipertiroidide geri dönüşlü psikoz ve mani: olgu sunumları ve olgu serilerinin sistematik derlemesi](https://alisanburak.com/en/wcp-2026-posterler/ev0340) - [Kronik somatik hastalıklarda (diabetes mellitus, arteriyel hipertansiyon ve kronik solunum hastalıkları) eşlik eden depresyon](https://alisanburak.com/en/wcp-2026-posterler/ev0344) [All WCP 2026 summaries](https://alisanburak.com/en/wcp-2026-posterler) --- Kaynak / Source: https://alisanburak.com/en/wcp-2026-posterler/so346 İletişim / Contact: Bağdat Caddesi, Veli Güneysu Apt. 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