Oral methadone dosing for chronic pain: practitioner's guide

Methadone, a strong opioid analgesic, is an effective and economical choice for the management of cancer pain and chronic noncancer pain, both as a first line medication and as a replacement opioid.

However, methadone-associated emergencies, overdoses, and deaths have increased, so there is a critical need for the proper prescribing and use of this medication.

Two new documents exclusively from Pain Treatment Topics help teach healthcare providers how to best prescribe methadone and provide special instructions for patients on how to safely use it…

“Oral Methadone Dosing for Chronic Pain: A Practitioner's Guide”

This 12-page guidance report by James D. Toombs, MD, cautions that methadone works differently than other opioid pain relievers. It is much more powerful than morphine, but there are significant differences in how patients respond to methadone. Furthermore, methadone can interact with a large number of other medications, so harmful drug interactions must be considered. At the same time, compared with other opioids, methadone is generally much less expensive, making effective pain relief affordable for all patients. Toombs' paper discusses these vital issues and provides specific guidance on how oral methadone should be dosed for best results and with the least risks of adverse reactions or overdose.

“Methadone Safety Handout for Patients” (in English and Spanish)

Stewart B. Leavitt, MA, PhD, editor of Pain Treatment Topics, has developed these special 2-page handouts for patients and their families or caregivers. They offer vital instructions for methadone treatment compliance and safety, and can be freely copied and provided to patients at the time they receive their methadone prescription from the healthcare provider. These easy-to-understand instructions warn patients that misuse or abuse of this strong opioid can have dire consequences, including overdose and death, and tell them how to avoid these hazards.