Open AccessWhen to use methadone for pain: A case-based approach
Author(s) -
Gayatri Palat,
Nandini Vallath,
Srini Chary,
Ann Broderick
Publication year - 2018
Publication title -
indian journal of palliative care/indian journal of palliative care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.395
H-Index - 26
eISSN - 1998-3735
pISSN - 0973-1075
DOI - 10.4103/ijpc.ijpc_182_17
Subject(s) - medicine , methadone , cancer pain , opioid , context (archaeology) , multidisciplinary approach , neuropathic pain , normative , multidisciplinary team , psychiatry , anesthesia , cancer , nursing , paleontology , social science , philosophy , receptor , epistemology , sociology , biology
The case studies are written in this article to illustrate how methadone might be used for pain in the Indian context. These cases might be used for discussion in a multidisciplinary team, or for individual study. It is important to understand that pain requires a multidisciplinary approach as opioids will assist only with physical, i.e. neuropathic and nociceptive pain, but not emotional, spiritual, or relational pain or the pain of immobility. The social determinants of pain were included to demonstrate how emotional, relational, and psychological dimensions of pain amplify the physical aspects of pain. The case studies follow a practical step-wise approach to pain while undergoing cancer treatment, pain toward the end-of-life and needing longer acting opioid. Methadone in children, and methadone in conditions of opioid toxicity or where there is a need for absorption in the proximal intestine cases are included.