Methadone analgesia in cancer pain patients on chronic methadone maintenance therapy.


Journal Article

Methadone is currently best known for its use as the maintenance drug in opioid addiction. The main concern when using methadone for the treatment of pain is its long and unpredictable half-life, which is associated with the risk of delayed toxicity. This may result in side effects such as sedation and respiratory depression if careful titration and close observation of individual patient responses are not performed. For this reason, methadone is often viewed as a second line opioid, after other opioids with a more predictable dose-response have been tried. We report six patients with long-term exposure to methadone as a treatment for heroin dependency, who were also treated with methadone for cancer pain. The first five patients were at least partially refractory to the analgesic effects of opioids other than methadone. All six patients achieved analgesia without sedation or respiratory depression from aggressive upward methadone titration. Methadone analgesia can be considered early in the course of treatment of patients with chronic exposure to methadone who develop new or worsening pain requiring opioid therapy.

Full Text

Cited Authors

  • Manfredi, PL; Gonzales, GR; Cheville, AL; Kornick, C; Payne, R

Published Date

  • February 2001

Published In

Volume / Issue

  • 21 / 2

Start / End Page

  • 169 - 174

PubMed ID

  • 11226767

Pubmed Central ID

  • 11226767

Electronic International Standard Serial Number (EISSN)

  • 1873-6513

International Standard Serial Number (ISSN)

  • 0885-3924

Digital Object Identifier (DOI)

  • 10.1016/s0885-3924(00)00252-9


  • eng