Treatment of pain in methadone-maintained patients

Mt Sinai J Med. Oct-Nov 2000;67(5-6):412-22.


Patients with opioid dependency experience trauma, acute medical illness and chronic diseases, and may have to undergo surgery to the same extent as other individuals. They need to be treated for relief of symptoms, including pain. Undertreatment or inadequate treatment of pain for these individuals is a particular problem because of opioid dependency and/or methadone maintenance treatment. The guiding principles governing treatment of these patients are to maintain the methadone treatment and to use short-acting narcotics administered at higher doses, and to do so as often as necessary, preferably on a fixed schedule, to relieve the pain. Supplemental analgesic medication may also be employed, except that opiate antagonists must be avoided.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Analgesics, Opioid / therapeutic use*
  • Female
  • HIV Infections / complications
  • Humans
  • Methadone / therapeutic use*
  • Neoplasms / complications
  • Opioid-Related Disorders / complications
  • Opioid-Related Disorders / drug therapy*
  • Pain / complications
  • Pain / drug therapy*
  • Pregnancy
  • Pregnancy Complications


  • Analgesics, Opioid
  • Methadone