What happens if I need pain medication and am on MMT?

When methadone was originally discovered in the late 1930s it was found to be an effective opioid agent to treat pain. So it is sometimes believed that persons taking the drug daily as part of a methadone maintenance treatment program for addiction do not feel physical pain like everybody else.

This is untrue – patients stabilized on methadone feel pain just like anybody else would. And, when it comes to treating pain, you will have the same needs as other people for adequate pain medication.

For average pain that doesn’t last very long – such as, a headache or muscle strain – over-the-counter painkillers (analgesics) should do the job. If pain is more severe and/or long-lasting, opioid painkillers with actions similar to morphine may need to be prescribed. Since your body is already used to an opioid drug (methadone), talk to your doctor about the various drugs available for your treatment. Additional medicines – like antidepressants or anti-seizure drugs – may be prescribed to help increase the effects of the analgesic.

Be aware that certain painkillers – such as, Buprenex ®, Dalgan ®, Nubain ®, Stadol ®, Subutex ®, Suboxone ®, Talwin ®, and Ultram ® – can block the effects of methadone and could bring on uncomfortable withdrawal symptoms. Also, Darvon ® and Demerol ® are not recommended because harmfully high doses may be needed for effective pain relief in a methadone-maintained person.

You definitely should inform the healthcare professionals treating your pain that you are on methadone maintenance. If they are unsure of how best to treat the pain, or seem reluctant to prescribe stronger medication, refer them to the medical staff at your methadone clinic. Never take non-prescribed medications or street drugs (including alcohol) along with pain medication or you could seriously harm yourself.

Sources:

Federal Regulation of Methadone Treatment. National Institute of Medicine. 1995. Available online at: http://www.nap.edu/books/0309052408/html/

Joseph H, et al. Methadone Maintenance Treatment (MMT): A Review of Historical and Clinical Issues. Mt Sinai J Med. 2000;67(5-6):347-364