• Sachin S Kale, TostoGennaro DiGDCenter for the Advancement of Team Science(G.D.T., L.J.R., A.S.M.), Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, USA., Laura J Rush, Justin Kullgren, Deborah Russell, Martin Fried, Blessing Igboeli, Julie Teater, Katie Fitzgerald Jones, Devon K Check, Jessica Merlin, and Ann Scheck McAlearney.
• Division of Palliative Medicine(S.S.K., J.K., D.R.), The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. Electronic address: Sachin.kale@osumc.edu.
• J Pain Symptom Manage. 2024 Aug 1; 68 (2): e138e145e138-e145.

BackgroundOpioids are a first-line treatment for severe cancer pain. However, clinicians may be reluctant to prescribe opioids for patients with concurrent substance use disorders (SUD) or clinical concerns about non-prescribed substance use.MeasuresPatient volume, 60-day retention rate, and use of sublingual buprenorphine to treat opioid use disorder.InterventionWe created the Palliative Harm Reduction and Resiliency Clinic, a palliative care clinic founded on harm reduction principles and including formal collaboration with addiction psychiatry.OutcomesDuring the first 18 months, patient volume increased steadily; 70% of patients had at least one subsequent visit within 60 days of the initial appointment; and buprenorphine was prescribed for 55% of patients with opioid use disorder.Conclusions/Lessons LearnedThe formal collaboration with addiction psychiatry and the integration of harm reduction principles and practices into ambulatory palliative care improved our ability to provide treatment to a previously underserved patient population with high symptom burden.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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