Postgrad Med J 80:654-659 doi:10.1136/pgmj.2004.022988
  • Review

Methadone: applied pharmacology and use as adjunctive treatment in chronic pain

  1. R Brown1,
  2. C Kraus2,
  3. M Fleming3,
  4. S Reddy4
  1. 1University of Wisconsin Department of Family Medicine and Department of Population Health Sciences, and Madison Health Services Methadone Treatment Facility, Madison, Wisconsin, USA
  2. 2University of Wisconsin Department of Pharmacy, Madison, Wisconsin, USA
  3. 3University of Wisconsin Department of Family Medicine, Madison, Wisconsin, USA
  4. 4University of Wisconsin Medical School, Madison, Wisconsin, USA
  1. Correspondence to:
 Dr Randall Brown
 University of Wisconsin Department of Family Medicine, 777 S Mills St, Madison, WI 53715, USA;
  • Received 14 April 2004
  • Accepted 10 May 2004


This article reviews the unique pharmacological properties of methadone and outlines its appropriate clinical application, with focus upon its use in the treatment of chronic pain. Although methadone is most widely known for its use in the treatment of opioid dependence, methadone also provides effective analgesia. Patients who experience inadequate pain relief or intolerable side effects with other opioids or who suffer from neuropathic pain may benefit from a transition to methadone as their analgesic agent. Adverse effects, particularly respiratory depression and death, make a fundamental knowledge of methadone’s pharmacological properties essential to the provider considering methadone as analgesic therapy for a patient with chronic pain.