When do Doctors Use Methadone for Pain Management?

Christa Roy

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.

Work with your doctor to develop a pain management approach that works for you.
Work with your doctor to develop a pain management approach that works for you.

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 use methadone for pain management as an alternative to more powerful drugs.
Physicians use methadone for pain management as an alternative to more powerful drugs.

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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Discussion Comments


@fBoyle-- It's fine for this drug to be used this way, but some doctors are even prescribing it for pain that is less than severe because it's effective and affordable. That's a terrible idea because it's just setting up people for addiction.

Methadone is believed to be as addictive as narcotics like heroin. It stays in the body for a very long time but it's pain-relieving effects don't last as long. So patients are tempted to take more and more. If a doctor prescribes this drug, there has to be a very tight control on the dosage and it should not be used longer than necessary. As patients express less pain, the dose should be tapered and eventually stopped altogether. The longer one uses it, the more difficult withdrawal will be.


@burcinc-- Methadone has actually become more popular as a treatment for chronic and severe pain in the recent years. My friend was on it for a while after surgery. It's also used in terminally ill patients and patients with cancer.


As far as I know, methadone is most often used to help people withdraw from addictions such as heroin. It's also used for pain management but this use is more like a second use. And like the article said, methadone is also very addictive. So I don't think most doctors would give this to their patients if other pain relievers are going to be effective. Because more than likely, when a patient uses methadone for pain management, they are going to be addicted to it somewhat and will experience withdraw symptoms.

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