Characteristics of methadone maintenance patients with chronic pain

Chronic pain patients who have limited access to opioids may be redirected to methadone maintenance centers for management of their pain. Unfortunatel y, little information exists on the incidence and characteristics of methad one maintenance patients with chronic pain. The aim of this study was to su rvey individuals at methadone maintenance centers in order to determine the prevalence of chronic pain and to explore differences between patients wit h and without pain in this treatment setting. Of 248 participants interview ed at three centers, 152 (61.3%) reported chronic pain. Compared with patie nts without pain, those with pain reported significantly more health proble ms (P < 0.001), more psychiatric disturbance (P < 0.05), more prescription and nonprescription medication use (P < 0.001), and greater belief that the y were undertreated (P < 0.001); 44% of those with pain believed that opioi ds prescribed for their pain had led to an addiction problem. Most of the m ethadone maintenance patients stated that they had always required some sub stance (alcohol or opioids) to feel normal. These results raise many questi ons about chronic-pain treatment policies and resources for persons with a history of substance abuse. Further investigations are needed to define the needs of this population and to improve their access to effective pain man agement. (C) U.S. Cancer Pain Relief Committee, 2000.