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Introduction
The opioid epidemic has been a major public health concern in the United States for several years and continues to cause significant morbidity and mortality throughout the country. As such, it is of utmost importance to understand the impact that it has had on opioid prescribing in hospice and palliative care settings. This dissertation will explore this issue through a qualitative description of the current trends and practices regarding opioid prescribing in these specialized settings, as well as their potential implications for patient outcomes.

Background
Opioids are powerful drugs that are commonly prescribed for pain management, but can lead to addiction or overdose if not used responsibly. Over the past two decades, over-prescribing of opioids has led to an increase in opioid use disorder (OUD) and overdose deaths across the US; according to data from the Centers for Disease Control (CDC), there were more than 70,000 drug overdose deaths linked to opioids in 2019 alone. This alarming trend prompted healthcare professionals, including those working in hospice and palliative care settings, to re-evaluate how they prescribe opioids so as to ensure safe yet effective pain relief for their patients.

Methods
In order to gain an understanding of how this shift has impacted opioid prescribing practices within hospice and palliative care settings, a qualitative description was conducted using case studies from various healthcare organizations across multiple states. The data collected included policy documents related to opioid prescribing; interviews with clinicians who provide hospice/palliative care services; information gathered from survey respondents about their experiences with prescription opioids; and other relevant literature focusing on issues related to OUD prevention within these types of medical settings. All cases were analyzed using thematic coding techniques which allowed us to identify key themes regarding changes that have occurred due to increased awareness on OUD prevention strategies among providers caring for patients at end-of-life stages (eol).

Results
The results revealed that many clinicians now take greater precautions when prescribing opioids by emphasizing non-pharmacological treatments such as physical therapy or counseling first before considering medication options; adhering strictly to evidence-based guidelines on appropriate doses; keeping detailed records of all prescriptions written out accurately with proper documentation; monitoring each patient’s progress closely during treatment periods; engaging families or caregivers when needed for additional support or guidance during treatment plans; educating eol patients about risks associated with pain medications prior starting any new prescriptions or titrating existing ones per individual needs & goals ;and being aware of resources available locally should any problems arise from possible misuse/overdose incidents . Overall ,these findings highlight some positive changes implemented since awareness was raised around OUD prevention efforts among providers offering patient facing services at end-of -life stages .

Discussion & Conclusion
This dissertation provides valuable insight into how recent developments surrounding heightened awareness about OUD prevention have resulted in changes made towards safer yet still effective ways of providing opiate analgesia within specialized settings like hospice/palliative care units nationally throughout America today . While further research is needed beyond qualitative descriptions in order quantify effects based off these newly adopted standards ,it is clear that by recognizing & responding appropriately too potential risks posed by inappropriate opiate prescription rates while still providing adequate levels pain relief– healthcare systems overall can benefit greatly going forward if necessary steps continue be taken prevent future cases mismanagement /abuse /overdose related emergencies occurring amongst both l populations receiving EOL services & those seeking alternative routes seek relief elsewhere outside typical realms medical structures altogether nonetheless

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