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Review
. 2018 Jan;24(Suppl 1):S15-S20.
doi: 10.4103/IJPC.IJPC_182_17.

When to Use Methadone for pain: A Case-Based Approach

Gayatri Palat  1 , Nandini Vallath  2 , Srini Chary  3 , Ann Broderick  4
Affiliations
Review

When to Use Methadone for pain: A Case-Based Approach

Gayatri Palat et al. Indian J Palliat Care. 2018 Jan.

Abstract

The case studies are written in this article to illustrate how methadone might be used for pain in the Indian context. These cases might be used for discussion in a multidisciplinary team, or for individual study. It is important to understand that pain requires a multidisciplinary approach as opioids will assist only with physical, i.e. neuropathic and nociceptive pain, but not emotional, spiritual, or relational pain or the pain of immobility. The social determinants of pain were included to demonstrate how emotional, relational, and psychological dimensions of pain amplify the physical aspects of pain. The case studies follow a practical step-wise approach to pain while undergoing cancer treatment, pain toward the end-of-life and needing longer acting opioid. Methadone in children, and methadone in conditions of opioid toxicity or where there is a need for absorption in the proximal intestine cases are included.

Keywords: Cancer treatment; children; end-of-life care; long-acting opioid; methadone; multidisciplinary approach; small intestinal absorption.

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Conflict of interest statement

There are no conflicts of interest.

References

    1. Haumann J, Geurts JW, van Kuijk SM, Kremer B, Joosten EA, van den Beuken-van Everdingen MH, et al. Methadone is superior to fentanyl in treating neuropathic pain in patients with head-and-neck cancer. Eur J Cancer. 2016;65:121–9. - PubMed
    1. Canadian Virtual Hospice. Methadone4pain Course. 2016. [Last accessed on 2017 Sep 15]. Available from: http://www.methadone4pain.ca .
    1. Salpeter SR, Buckley JS, Bruera E. The use of very-low-dose methadone for palliative pain control and the prevention of opioid hyperalgesia. J Palliat Med. 2013;16:616–22. - PMC - PubMed
    1. Reddy SK. Pain management. In: Elsayem A, Driver L, Bruera E, editors. The M.D. Anderson Symptom Control and Palliative Care Handbook. 2nd ed. Houston: M.D. Anderson Cancer Center; 2004. p. 38.
    1. de Stoutz ND, Bruera E, Suarez-Almazor M. Opioid rotation for toxicity reduction in terminal cancer patients. J Pain Symptom Manage. 1995;10:378–84. - PubMed