Methadone In Chronic Non-Oncological Pain: From Disassuefaction Of Painkillers Abuse To The Primary Management Of Opioid Hyperalgesia

Abstract

BACKGROUND AND AIMS Methadone is a well-known drug for the treatment of heroinopathy but its role as an analgesic is often forgotten, especially in primary and non-specialist medicine settings. In this article we want to describe its characteristics in this application not only for the cessation of painkillers but above all for the management of neuropathic pain and hyperalgesia induced by opioid therapy in the long term. METHODS The article was written by referring both to the technical data sheets of the drug and by associating research in paper and online books on databases such as Scopus, PubMed, Cochrane Library and Embase. DISCUSSION AND CONCLUSIONS Methadone remains a mysterious but at the same time fascinating drug, both for the aura of mystery around its name, frowned upon by both patients and prescribers, but at the same time unparalleled in terms of efficacy for analgesia in cancer pain and not, especially in patients who have lost sensitivity to other opioids even more potent than methadone such as fentanyl. In other words, the efficacy in the cessation of abusers of painkillers both for recreational purposes and secondary to background pain now no longer controlled makes this drug unique as a maintenance therapy.