| Methadone Questions and Answers: |
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Methadone and Pain:
Methadone was developed over 55 years ago as an Opioid medication to treat pain. It is sometimes believed that people regularly taking Methadone as a part of MMT (to treat drug addiction) don’t feel physical pain like everyone else does. This is absolutely False. Why doesn’t methadone (as part of MMT) block pain? An adequate maintenance dose of methadone everyday takes away cravings for opioid drugs and allows the person to live a better life. But the body becomes used to the pain-relieving quality of methadone. This is called tolerance to the drug. This means that an MMT patient will feel pain just like someone who has never taken methadone. When appropriate, he/she will need painkilling medication, possibly including opioid based medication as well. What if the pain goes untreated? Aside from the obvious physical discomfort caused by the pain, there can be some serious health consequences. Healing may be delayed. Increased stress may disturb appetite and sleep. The person may have feeling of powerlessness, hopelessness, and depression. Such distress might lead to a relapse to “street drugs”. So it is wise to have his/her pain treated properly, rather than make the patient suffer in silence. How does methadone work, to treat pain? There are many different painkilling medicines, called analgesics. The World Health Org. has recommended several levels of treatment, depending on the type of pain. For average pain that doesn’t last very long, such as headache or muscle strain, over-the-counter analgesics might be recommended. These include aspirin, other non-steroidal anti-inflammatory drugs such as ibuprofen, or Tylenol. If pain is more severe and/or long lasting, opioid analgesics with action similar to morphine may need to be prescribed. Additional medicines may be prescribed to help increase the effects of analgesics. Are there any painkillers to avoid while on MMT? Certain painkillers fight against methadone and can cause uncomfortable withdraw symptoms. Known as opioid partial agonist or mixed agonist/antagonist drugs – like Buprenex, Nubain, Stadol, Talacen, Talwin – they should be avoided. Also, Darvon and Demerol are not recommended because harmfully high doses could be needed for pain relief in a methadone-maintained person. Should the patient continue to stay on methadone, while being treated for pain? While you are being treated for pain, there is no need, nor would it be helpful, to stop or change – increase or decrease – your methadone maintenance dose. If you are treated by outside professionals, such as at a hospital, you should ask your clinic’s staff to help make sure you are continued on methadone as usual. Persons taking adequate maintenance doses of methadone do not feel increased drug cravings or get “high” when given opioid analgesics for pain. However, to avoid dependence on painkillers, it is important to stop taking the medicines according to doctor’s directions once the pain is better. What should a MMT patient do? Be honest. Tell all your doctors, dentists, nurses, and other medical professionals treating you that you are on methadone maintenance and of your past drug history, so they can prescribe the best and safest medication. Encourage them to talk to your MMT clinic doctor and staff, with your permission. Ask for the name of the pain medication and for assurances that it will mix safely with methadone. Follow directions exactly, taking too much of any painkiller can be harmful or fatal. Let your health care providers know how the medication is working, so they can change the dose or the medication if necessary. Be cautious about advice offered by other people. What works for one person may not work for you or even be harmful. Keep in mind that taking any other drugs with pain medicines, especially “street drugs” or alcohol, can be dangerous or even fatal. Whenever you have questions or concerns, talk to your clinic staff. |
