Category: Articles

Maximizing Safety with Methadone & Other Opioids

Opioids provide life-saving analgesia for the millions of Americans who suffer with chronic pain, yet overdose deaths are rising at an alarming rate, with methadone implicated to a disproportionate degree [Paulozzi et al. 2006; Webster 2005; Warner et al. 2009]. Methadone deaths increased almost seven-fold from 790 in 1999 to 5,420 in 2006, rising faster More Info »

Oral Methadone Dosing for Chronic Pain: A Practitioner’s Guide

Methadone has emerged as a good choice for the management of cancer pain and chronic non-cancer pain both as a first-line medication and as a replacement opioid. Particular cautions must be observed as methadone’s pharmacokinetics and pharmacodynamics are unique among opioids. Milligram for milligram, however, methadone is much more powerful than morphine, although there is More Info »

Commonsense Opioid-Risk Management in Chronic Noncancer Pain: A Clinician’s Perspective

Chronic noncancer pain (CNP) is a serious and likely undertreated public health problem. In a 2005 survey, 19% of US adults reported chronic pain and 34% reported recurrent pain [Kuehn 2007]. The annual costs of pain-related healthcare, litigation, and compensation are estimated at $100 billion in the United States alone [Sinatra 2006]. While opioids have More Info »

Pain in Opioid-Addicted Patients Entering Addiction Treatment

Pain and addiction share some common physiologic pathways in the brain, especially those involving opioids, and each may affect the other. That is, the presence of pain may influence the development and course of opioid addiction, and vice versa (Compton and Gebhart 2003). These interactions may complicate therapy for opioid addiction. For example, opioid-addicted persons More Info »

Methadone Cardiac Concerns

Some patients in methadone maintenance treatment (MMT) programs may have conditions or behaviors associated with increased risks of arrhythmia, including: abuse of cardiotoxic substances, cardiovascular disease, electrolyte imbalances, and prescribed medications that may foster cardiac repolarization disturbances. Furthermore, recent data suggest that in some individuals methadone – alone or, more commonly, in combination with other More Info »

Methadone-Drug Interactions (Medications, illicit drugs, & other substances)

Each year in the U.S. there are innumerable adverse drug reactions, broadly defined as any unexpected, unintended, undesired, or excessive response to a medicine. Such reactions may require discontinuing or changing medication therapy. Furthermore, greater than 2 million of those are serious reactions resulting in hospitalization and/or permanent disability, and there are more than 100,000 More Info »

Patient Instructions Handout: Safely Taking Oxycodone

Most patients and their families or caregivers find the medication information provided by pharmacies, or product package inserts (if provided), difficult to read and understand. Hence, they are of little help as a safety measure. Opioid medications must especially be safeguarded by patients. Recent data suggest that teenage pilferage and illicit use of prescription opioids More Info »

Opioid Tapering: Safely Discontinuing Opioid Analgesics

Severe hurricanes in the Gulf Coast during 2005 caused many hardships for patients and healthcare providers alike. An important concern coming to light during this time of crisis was the inability to obtain prescription medications, including opioid analgesics. Patients with chronic pain and their healthcare providers faced the daunting task of either somehow procuring the More Info »

Commonsense Oxycodone Prescribing & Safety

Oxycodone is FDA-approved for treating moderate to severe pain that is either acute or chronic in nature. It has been widely used in pain management practice for decades but has recently been receiving much negative attention due to abuse, overdose, and deaths associated with the controlled-release formulation. So, in the overall approach to pain management, More Info »

Opioid Safety in Patients With Renal or Hepatic Dysfunction

It has been estimated that up to one-third of patients with renal dysfunction (defined as creatinine clearance [CrCl] < 50 mL/min) also receive opioids to relieve pain [Davison 2003]. Use of opioids in these patients can present a challenge because adequate pain control is necessary while balancing the risk of overdose due to altered drug More Info »