Table of Contents
Preface/Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3Scope and Purpose. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4The Pharmacology of Methadone. . . . . . . . . . . . . . . . . . . . . . . .5Methadone Maintenance Treatment (MMT) for Opioid Addiction. . .5Methadone for Chronic Pain Management. . . . . . . . . . . . . . . . . .7Group I: Primary Pain patients. . . . . . . . . . . . . . . . . . . . . . . .7Group II:
Pain patients with past or active substance dependence
. .7Group III: Pain patients with concurrent opioid addiction. . . .8Using Methadone to Treat Pain. . . . . . . . . . . . . . . . . . . . . . . . . .9 Assessment Phase. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9Treatment Phase. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10Informed Consent/Treatment Agreements. . . . . . . . . . . . . .11Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11Specific Cautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12The Role of Family and Supportive Others. . . . . . . . . . . . . .12Misuse/Diversion of Methadone. . . . . . . . . . . . . . . . . . . . . .13Documentation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13Methadone Dosing in the Management of Pain. . . . . . . . . . . . .13Prescribing and Dispensing. . . . . . . . . . . . . . . . . . . . . . . . .14General Considerations. . . . . . . . . . . . . . . . . . . . . . . . . .14Methadone Availability. . . . . . . . . . . . . . . . . . . . . . . . . .14Opioid Naïve Patients. . . . . . . . . . . . . . . . . . . . . . . . . . .16Changing to Methadone. . . . . . . . . . . . . . . . . . . . . . . . .17 Withdrawal Mediated Pain. . . . . . . . . . . . . . . . . . . . . . . . . . . .181
METHADONE
for pain
GUIDELINES
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Hey everyone!! I'm new to the site, and thankful I've found so many people that share my "pain" problems and issues!! I have aquestion...preferably looking for someone who has experience with fentynal ansd methadone. i have been on 100mcg transdermal Fentynal patches for 2 months...worked up to it over a few months...and take 8 5mg oxycodone IR daily for breaktrough pain. I'm also on Valium for my
My family Dr. Doreen Morris, wrote my pain medication for me every month. Then she up and moved away, making me scramble looking for a new DR. that would write for my pain meds. Methadone. It is the only pain med that sufficiantly gets rid of my pain. I live in NW PA. Can anybody help me find a Dr. that will write my pain meds for me?
I really need help I came out of province and am taking matadol form of methadone (pill form) and I had to miss my flight back to work on my 20day shift I cannot for the life of me find a methadone doc that will prescribe metadol and am willing to drive almost anywhere in ontario for a doc to assist me if i do not find sombosy in the next day by friday the very latest I am going to be not only sick and in pain but without a job also this is absolutely rediculous ...WHO CARES? ANYBODY?if anybody can help me please e-mail yourfriendray59@yahoo.ca its oct 1st
being on oxycontin for pain now doctors want to put me on methadone for addiction.....but what about my prime problem , which is PAIN?...is this normal?
hey, if the docs have expressed that they think you either need to stop or cut back on the oxy's...then the methadone would help with that...I just got methadone added to my pain management treatment...to treat pain....so It might help? I hope it works out for you!!
I tried 10 mg. methedone for back pain, but five or six hours later it made me vomit. Is this normal?
Sometimes it is better to start out taking a real low dose. Cut the pill in quarters. Working your way up to the full pill. The smaller dose won't take your pain away, but it will get your system ready for the whole pill. You will see when taking the full amount will give you great pain relief. I take 4 10mg pills 4 times a day. And it gives me great pain relief.