Understanding where people with opioid use disorder die: why palliative care setting matters
01/20/2026
Despite increasing attention to the opioid toxicity crisis, little is known about how palliative care influences end-of-life experiences for people with opioid use disorder (OUD). A new study published in the Journal of Palliative Care examines how receipt of palliative care relates to the location of death among adults with OUD.
“People with OUD face profound health challenges, including high rates of comorbid illness and premature mortality,” said Lisa Boucher, Postdoctoral Fellow at Bruyère Health Research Institute and lead author of the study. “Yet socioeconomic disadvantages disproportionately impact people with OUD, limiting their ability to access and receive palliative care or die in preferred settings.”
Using health administrative data in Ontario, researchers identified 11,200 adults with OUD who died between 2015 and 2021 who received inpatient, outpatient, or no palliative care before their last 90 days of life, looking at their location of death.
Half of the decedents had no palliative care before their final three months. Among those who did receive care, two-thirds received inpatient-only palliative care, while only about one-third had any outpatient involvement.
Inpatient-only palliative care was associated with a small decrease in the likelihood of dying in the community compared with no palliative care, with the exception of those who had cancer. Outpatient palliative care did not show a clear relationship with place of death, again, except for those who had cancer, where receiving outpatient palliative care was associated with a greater likelihood of a community death.
“Many patients express a preference to die at home or in community settings versus dying in a hospital, and place of death is commonly used as a quality indicator in palliative care,” said Boucher. “Though we are seeing greater recognition of palliative care access disparities for marginalized groups, we need to understand how end-of-life outcomes for people with OUD align with their preferences and needs, and whether structural factors—such as access, social supports, and stigma—shape where and how they receive care and die.”
"Relationship Between Palliative Care and Location of Death Among People With Opioid Use Disorder: A Retrospective Cohort Study" was published in Journal of Palliative Care.
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This study was funded in part by the Canadian Institutes of Health Research and Health Canada's Health Care Policy and Strategies Program.