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Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches pp 145–150Cite as

Methadone for Chronic Pain

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Abstract

Methadone use for pain relief has surged over the past two decades. In this time, its special pharmacology has been elucidated which has led to speculation about special properties as well as far greater risks than with other opioid medications. Recently, increasing reports of methadone-related unintended deaths have spurred greater concern about this unique drug. Methadone has many advantages that are now well opposed by many posing serious risks for patients in pain. Advantages include cost, ease of use, and multiple opioid and non-opioid receptor actions. However, risks include metabolic instability related to unique P450 system hepatic clearance that poses drug-drug interactions that differ from other opioids, high protein binding, variable urine clearance, and the potential for cardiac arrhythmia. Thus, this drug that saw a renaissance over the past two decades has now been revealed as more dangerous than previously thought and widely noted to require heightened knowledge and risk management for safe use.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, UC-Davis Medical Center, 4860 Y Street, Suite 3020, Sacramento, CA, 95817, USA

    Naileshni Singh M.D.

  2. University of California, Davis School of Medicine, Sacramento, CA, USA

    Naileshni Singh M.D.

  3. Division of Pain Medicine, Department of Anesthesiology and Pain Medicine, University of California, Davis School of Medicine, 4860 Y Street, Suite 3020, Sacramento, CA, 95817, USA

    Scott M. Fishman M.D.

  4. Department of Anesthesiology, Naval Medical Center, San Diego, 2736 West Canyon Ave, San Diego, CA, 92123, USA

    Kyle Tokarz DO

Authors
  1. Naileshni Singh M.D.
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  2. Scott M. Fishman M.D.
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  3. Kyle Tokarz DO
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Corresponding author

Correspondence to Naileshni Singh M.D. .

Editor information

Editors and Affiliations

  1. The Center for Pain Relief, Inc., West Virginia University, 400 Court Street, Suite 100, Charleston, 25301, West Virginia, USA

    Timothy R. Deer

  2. Stanford Pain Management Center, Redwood City, CA, Clinic Chief, Stanford University School of Medicine, Stanford, 94065, California, USA

    Michael S. Leong

  3. Department of Anesthesiology, Rush Medical College, Professor, Rush University Medical Center, Chicago, 60612, Illinois, USA

    Asokumar Buvanendran

  4. Pennsylvania State University, College of Medicine, Department of Anesthesiology, Milton S. Hershey Medical Center, Hershey, 17033-0850, Pennsylvania, USA

    Vitaly Gordin

  5. Center for Interventional Pain and Spine, Newark, DE USA, Medical Director, Bryn Mawr Hospital, Bryn Mawr, 19010, Pennsylvania, USA

    Philip S. Kim

  6. President, National Institute of Pain, Tampa, 33558, Florida, USA

    Sunil J. Panchal

  7. The LITE Center, Clinical Associate Professor, Medical Director, School of Medicine, Miami, 33143, Florida, USA

    Albert L. Ray

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© 2013 American Academy of Pain Medicine

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Singh, N., Fishman, S.M., Tokarz, K. (2013). Methadone for Chronic Pain. In: Deer, T., et al. Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1560-2_14

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  • DOI: https://doi.org/10.1007/978-1-4614-1560-2_14

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-1559-6

  • Online ISBN: 978-1-4614-1560-2

  • eBook Packages: MedicineMedicine (R0)

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