Methadone for Chronic Pain

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Many people have heard of methadone, but not for its analgesic properties. Mostly often, methoadone is known for its use as a detoxification treatment of narcotic addiction and for short term treatment afterwards.

However, methadone is often used for treatment of severe pain, especially in cancer patients. The American Academy of Family Physicians reports that 80 percent of patients reported improvement in pain control and reduction of adverse effects following transition to methadone in a study of cancer patients who had either significant side effects from other opioids or uncontrolled pain despite being on opioids.

The advantages of methadone for pain management is that it is often cheaper than morphine and it is usually well tolerated, particularly in patients who do not do well on morpine. In addition, there is a long duration of action with methadone.

The problem with using methadone for chronic pain is that opioids become less effective as the body becomes accustomed to it. The American Pain Society recommends that these physician guidelines be followed with methadone for chronic pain treatment:

• patients should be assessed for risk of abuse,
• comorbid mental disease should be ruled out
• doing should be used cautiously when switching
• avoiding combining certain medications,
• assess for sleep apnea,
• decrease dose during upper respiratory infections,
• avoid use of other long-acting opioids for acute pain.
In addition, the US Food and Drug administration started a campaign to raise awareness about the potential risks of using methadone as a chronic pain medication. In particular, the FDA is concerned about the potential of accidental overdose.

Methadone should be taken exactly as prescribed, and take it at the same time every day. Even a slight dosing error, such as taking a dose at night and then a second dose the next morning could lead to overdose complications.

Methadone for chronic pain treatment may be appropriate in some cases, but people with chronic pain that is not being managed should see an experienced pain management professional.

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