Prescribed, 300 mg of Methadone/day!

Methadone: date synthesized 1937
1950-used in treating opioid withdrawal in US
1964-Used in Opioid maintenance therapy

Yep, I’ve seen it!

It brings up several questions:


In this case, it was being given in the context of chronic pain management.

Chronic opioid therapy (the therapeutic use of opioid medications over a long period of time) is usually prescribed in the context of adult chronic pain management or medication-assisted treatment of opioid use disorders/addiction.

Why so much?

Undoubtedly, this is a very high dose of this opioid medication.

Methadone is approved/prescribed as an analgesic (pain killer) for severe pain or to treat opioid use disorder/addiction.

Initial doses typically begin at 5 or 10 mg, for analgesia in opioid-naive patients, and up to 40 mg in opioid-tolerant patients.

Patients/clients aren’t routinely started at such high dosage levels. Over time, however, depending on the goals of therapy, such doses may be gradually attained, generally by the process of slow titration (accumulation) of the medication, as the person’s tolerance for the opioid medication also rises.

This is what keeps the process safe.

 Still, there may be some question as to why such a high dose is required to attain the therapeutic goal.

Is it dangerous?

Yes, potentially. Opioid medications have many side effects and dangers if misused. Both the prescriber and the person taking the drug should be aware of this and appropriate precautions are taken to minimize complications. All medicines have side/undesirable effects, and some are unavoidable.

 One crucial caveat when taking opioid medications is to not combine their use with other sedating medications or products.

Clients/patients prescribed/taking opioid medications should be monitored closely for adverse reactions/situations. These should be discussed before embarking on this therapy, and patients/clients should be appropriately screened before prescribing opioid medications. 

Is it appropriate?

Opioid medication use and chronic opioid therapy are appropriate for the correct indications and under the right circumstances.

The medical community is still learning how to prescribe opioids safely, especially chronically. Before prescribing, prescribers should appropriately screen their patients, no different than for any other medication, alerting them to the unique dangers inherent to opioid drugs. After prescribing, frequent, ongoing monitoring of medication use, effectiveness, etc is necessary.#methadone #opioids #opioid treatment

Published by pcmed1119

I'm an Anesthesiology & Pain management-trained physician who has been professionally/clinically involved with/practicing in the field of opiate addiction medication-assisted treatments since 2006. I'd like to share my knowledge, perspectives and experiences here to benefit those interested in Opioid use disorder medication-assisted treatments and related issues.

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