Volume 67 Number 5&6 October & November 2000	back to contents

Treatment of Pain in Methadone-Maintained Patients	412-422
Michael M. Scimeca, M.D., Seddon R. Savage M.D., Russell Portenoy, M.D., and Joyce Lowinson, M.D.
Address correspondence to Michael M. Scimeca, M.D., Director, Department of Addiction Medicine, St. Barnabas Hospital, Third Avenue and 183rd Street, Bronx, NY 10457-2594.

ABSTRACT
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.

KEY WORDS
Tolerance, methadone, analgesic, methadone maintenance, pain, pain treatment, opiate, opioid, heroin, analgesia

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