When Do Doctors Use Methadone for Pain Management?

Physicians use methadone for pain management as an alternative to more powerful drugs.
Work with your doctor to develop a pain management approach that works for you.
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  • Written By: Christa Roy
  • Edited By: Angela B.
  • Last Modified Date: 10 November 2014
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Methadone is a synthetic opioid used as an analgesic, antitussive and anti-addictive. Physicians use methadone for pain management as an alternative to more powerful drugs available to treat pain. Weighing the pros and cons can be difficult for a physician when considering the use of methadone for pain management. Physicians use extreme caution when prescribing methadone because, even though it considered an anti-addictive, it is highly addictive in its own right.

Patients who suffer from chronic pain can build up a tolerance for many narcotics, such as hydrocodone, morphine and oxycotin. When this happens, most narcotics will no longer benefit the patient. In an effort to prevent this problem, physicians have begun to use a system called opioid rotation, which involves switching to another opioid at a lower dose when indications are that the first opioid is no longer having its maximum effect.

Physicians have starting using methadone for pain management, especially as part of this opioid rotation, because it can be given at a lower dose than most narcotics. This allows the physician to be able to increase the amount if needed to better relieve pain. Some patients who have been using different narcotics for pain relief will notice a change in their level of pain relief when taking methadone.


Most physicians will use methadone for pain management if the patient has severe or debilitating chronic pain. Methadone was once given only to patients suffering from a terminal disease, such as cancer. It was prescribed to make the patient comfortable during his final days.

Methadone was invented as an opiate replacement therapy. Physicians would prescribe methadone to patients addicted to narcotics. This would help ease withdrawal symptoms by replacing the narcotic with methadone and slowly lowering the dose. When prescribed to treat addiction, the patient is required to visit a clinic daily to get his dose for the day.

The use of methadone for pain management usually involves taking a dose every four to 12 hours. It works by changing the way the nervous system and the brain responds to pain. Methadone is classified as an opiate narcotic analgesic. Dosages can be increased and decreased by a physician, according to the patient’s pain level.

When taking methadone for pain management, the patient should take it only as prescribed. Methadone has a slow metabolism; this causes it to last longer in the body than most narcotics. If taken correctly it will relieve pain for a longer amount of time and patients will not have to take it as often as they would other medicines.

Physicians who prescribe methadone for pain management monitor this drug closely. Methadone is highly addictive even though it is used to help patients overcome addictions. A physician should stop treatment of methadone slowly to prevent withdrawal symptoms.


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