One of the main issues when prescribing medication for chronic pain is how much medication should be given and at what frequency. The result is that patient follow up care requires regular office visits and for the staff a lot of additional paperwork. The Pain Centre of Montreal University Health Centre has found an unique answer. They use methadone.
Most people think of drug addiction treatment when they hear methadone. The same reason that makes it well suited for drug addiction treatment is the same reason it is well suited for chronic pain; the body metabolizes methadone slowly.
Before implementing the program to current chronic pain patients in the center, a 9 month study of 75 patients was first conducted. Patients, with their family members, began with an education session. They received medication information and treatment guidelines, as well as a diary so they could note any related changes of pain intensity, and its associated impact on mood and activities.
Phone calls were made to the patients to allow nurses (in consultation with a physician) to adjust the treatment as needed. In approximately 25% of the time the dosage was increased and in approximately 5% of the time the dosage was either decreased or ceased altogether.
The advantage of using methadone as a management tool for chronic pain is that it does not create a lot of additional paperwork for the nurses and facilitates patient follow up because the patient’s office visits are minimized.