Tuesday, October 07, 2008

Q&A: Methadone Patient Recently Diagnosed With Cancer Asks if Methadone Can Be Used to Treat Pain

This question was submitted to our website and we thought it might be helpful for a larger audience (all names and personal references have been removed to protect confidentiality):

Q: I was taking methadone when I was recently diagnosed with Cancer. My cancer doctor wants me to stay on methadone for pain relief and I was wondering what dose would work for cancer to take the pain away. As far as I am concerned methadone is not working to relieve my pain. I was on the methadone due to my addiction before I found out about my cancer. If you could tell me if methadone can be used for pain relief of cancer patients it would be great.

A: Unfortunately many physicians think the daily methadone maintenance dose taken to treat addiction provides adequate pain relief throughout the day when it does not. Methadone is a very strong pain medication and is often used to treat cancer pain. It may be used for pain control in those also receiving methadone maintenance for addiction. If so, additional methadone is given for pain several times a day for the control of pain. The methadone maintenance treatment for addiction is continued at the usual dose and time. The methadone maintenance dose used to treat addiction usually will not provide pain relief, but if it does the pain relief will not last very long.

Whether or not methadone is used to treat your pain, the methadone maintenance dose should be continued. The medication given for pain should be started at the high end of the recommended starting dose and increased by your doctor as needed. Relatively high doses of opioid medication (for example morphine and methadone) may be required for good pain control. The only way the physician can tell if your pain is adequately treated is if you tell the physician. There is no upper dosage limit of medication which can be used as long as dangerous side effects such as drowsiness, muscle twitching or seizures do not occur. Everyone is different and different doses of the same medication for different patients with the same type of pain may be needed.

If your cancer doctor is unable to treat your pain adequately, you should request a consultation with a pain management specialist or palliative care doctor.


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