Posts Tagged ‘pain management’

The Use of Very-Low-Dose Methadone for Palliative Pain Control and the Prevention of Opioid Hyperalgesia.

J Palliat Med. 2013 Apr 4;
Salpeter SR, Buckley JS, Bruera E

Problem based review: The patient taking methadone.

Acute Med. 2013; 12(1): 51-4
Arora A, Williams K

Methadone Maintenance Treatment (MMT) is an effective therapy for opioid-dependence; its use is based on a harm reduction philosophy and represents one of a range of treatment approaches for opioid-dependent individuals. The medical literature supports MMT as a well established and cost-effective treatment for opioid-dependence that allows a return-to-normal physiological, psychological and societal functioning. The effectiveness of MMT is enhanced by psycho-social interventions such as contingency management and addressing other co-existing health and social needs. MMT saves lives and reduces violent and non-violent crime, drug use and the transmission of HIV, hepatitis C and other communicable diseases. For some people, MMT may continue for life, while others may eventually be able to discontinue and remain abstinent. Methadone interacts with numerous drugs and prolongs the corrected QT interval (QTc) with risk of sudden cardiac death. It has a prolonged half-life and premature discharge of patients after methadone overdose may be fatal. Each patient must be assessed, treated and monitored on an individual basis. Successful outcomes through MMT require knowledge, experience, vigilance, and diligence on the part of the physician, the patient and all of those involved in treatment.
HubMed – Methadone

A Comparison of Buprenorphine + Naloxone to Buprenorphine and Methadone in the Treatment of Opioid Dependence during Pregnancy: Maternal and Neonatal Outcomes.

Subst Abuse. 2013; 7: 61-74
Lund IO, Fischer G, Welle-Strand GK, O’Grady KE, Debelak K, Morrone WR, Jones HE

Given that buprenorphine + naloxone is prescribed for opioid-dependent pregnant women, it is important to examine the extent to which it differs from buprenorphine alone, methadone, or methadone-assisted withdrawal on neonatal and maternal outcomes. Summary statistics on maternal and neonatal outcomes were collected from 7 previously published studies examining treatment for opioid-dependent pregnant women that represented a range of research methodologies. Outcomes from these studies were compared to the same outcomes for 10 women treated with the combined buprenorphine + naloxone product. There were no significant differences in maternal outcomes for buprenorphine + naloxone compared to buprenorphine, methadone, or methadone-assisted withdrawal. Preliminary findings suggest no significant adverse maternal or neonatal outcomes related to the use of buprenorphine + naloxone for the treatment of opioid dependence during pregnancy. However, further research should examine possible differences between buprenorphine + naloxone and buprenorphine alone or methadone in fetal physical development.
HubMed – Methadone

Pharmacovigilance: a review of opioid-induced respiratory depression in chronic pain patients.

Pain Physician. 2013 Mar; 16(2): E85-94
Dahan A, Overdyk F, Smith T, Aarts L, Niesters M

Commissioner’s view: Take action on methadone, other drugs – Budgeteer

Commissioner's view: Take action on methadone, other drugs Budgeteer Our proposal focuses on prevention. Methadone treatment programs would be required to take advantage of the Prescription Monitoring Program, a tool that can help ensure patients are not accessing methadone or other pain-control medications from other …

Methadone Treatment – Google News

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Question by troubledinparadise: Methadone/opiates and pregnancy – For medical professionals only, please.?
I am a 32 y/o woman with extreme back & neck pain which has gotten progressively worse over the last 12 years. 2+ years ago when I became pregnant (unexpectedly) I was on very high amounts of opiate pain medications (160 mg oxycontin, 10-15 percocets/day, + anti-depressants, Vallium, etc.). Immediately upon finding I was pregnant I began speaking with my doctors about decreasing and eventually getting off all medications. I was very concerned about my baby being born addicted and having to go through withdrawal symptoms and after much debate, my doctor (OB and pain management) assured me it was safe for me to detox off of my medication. It was difficult but I did it. I ceased most meds and decreased the opiates (oxycontin) to 10 mg. twice a day which my OB and the local university hospital decided was where I should stay through delivery.