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Methadone treatment of chronic non‐malignant pain and opioid dependence — A long‐term follow‐up
Author(s) -
Rhodin A.,
Grönbladh L.,
Nilsson L.H.,
Gordh T.
Publication year - 2006
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1016/j.ejpain.2005.05.003
Subject(s) - methadone , medicine , quality of life (healthcare) , chronic pain , opioid , anesthesia , addiction , adverse effect , nausea , methadone maintenance , physical therapy , psychiatry , receptor , nursing
Iatrogenic opioid addiction among chronic pain patients was the initiative for starting a methadone programme for pain patients at the University Hospital of Uppsala. The aims were to improve pain relief and quality of life in pain patients with problematic opioid use and to investigate background factors explaining problems with opioid use. Methods Records of all 60 patients included in the methadone programme 1994–2002 were studied. An interview was done after a mean of 34 months of methadone treatment regarding pain relief, quality of life and side effects on 48 patients. Results Titration of oral methadone mixture in daily doses ranging from 10 to 350 mg (mean 99.5 mg) was done on all patients. Background factors were low back and musculoskeletal pain in 40%, psychiatric disease in 68%, and substance use disorder in 32% of the patients. Before methadone treatment all patients were on sick leave. After treatment five patients returned to work. Ten patients failed treatment, 4 due to intractable nausea, 4 to drug diversion, 1 because of methadone related arrhythmia and 1 because of insufficient analgesia. Pain relief was rated good by 75% and moderate by 25% of the patients. Global quality of life was rated at mean of 50(0‐100), which favourably compares with Swedish chronic pain patients mean 33(0‐100). Conclusion A structured methadone programme can be used for treating chronic pain patients with opioid dependence improving pain relief and quality of life. However, side effects and serious adverse events may limit the beneficial effects of the method.