February 21, 2009 at 10:52 pm

I have never taken methadone myself, but I work with children with cancer, some of whom have bad chronic pain. I have seen lives transformed when they switched to methodone. Before the side effects of other narcotics ruled their lives (sleepiness, itching, urinary retention, preoccupation with medicines because most others do not necessarily work very long or consistently so pain was up and down); after pain was much better controlled and more consistently and life was much more lived. Because methodone does not give so much the “high” that other narcotics can do, there was less concern about psychological effects in the survivors and it was easier to wean off when they no longer needed it. I would strongly advocate for this if chronic constant severe pain is a part of anyone’s life.
There is a stigma because of its use for heroin addition in the past, but this does not negate that it is one of the better pain medications. You do have to be careful in starting it because it has a long half life and it is rather easy to get too much as it builds up because medical people are more used to other narcotics that come to steady state levels a lot faster.
This being said, I also agree with others that for neuropathic pain, medicines for that type of pain are preferrable– such as neurontin or Lyrica. But many people have other kinds of pain as well as neuropathic pain or cannot take these medications.
There are a lot of people that cannot get good pain management because society is so leary of pain medications including, unfortunately, many doctors and there are lots of state restrictions, etc. There seem to be fewer stressors on filling methadone prescriptions than many other types of narcotics for severe pain because there are fewer worries (on doctor and patient side) about misuse or use of drugs for escapism. It has seemed to me that people are better able to concentrate on living life when the person in pain is on methadone. I do not say that this is the way society should be, but it often the way it is and it is worth saying that reducing that stress in communication is a good thing.
WithHope for a cure of these diseases