Related Experiment Video

Updated: Sep 27, 2025

Assessment of Morphine-induced Hyperalgesia and Analgesic Tolerance in Mice Using Thermal and Mechanical Nociceptive Modalities
07:23

Assessment of Morphine-induced Hyperalgesia and Analgesic Tolerance in Mice Using Thermal and Mechanical Nociceptive Modalities

Published on: July 29, 2014

33.5K

Rediscovery of Methadone to Improve Outcomes in Pain Management

Gloria Lai1, Edwin N Aroke2, Sarah Jingying Zhang3

  • 1Department of Anesthesiology, University of California San Francisco, San Francisco, CA.

Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses
|April 9, 2022
PubMed

Insights

Methadone, primarily used for opioid maintenance, offers potent pain relief through unique mechanisms. Emerging evidence supports its broader application in managing acute and chronic pain, even in opioid-naïve patients.

Area of Science:

  • Pharmacology
  • Pain Management
  • Anesthesiology

Background:

  • Methadone is recognized for opioid maintenance therapy.
  • Its pharmacological profile suggests significant analgesic potential beyond maintenance.
  • Current use in acute and chronic pain, especially for opioid-naïve individuals, is limited.

Purpose of the Study:

  • To explore methadone's unique pharmacology for pain management.
  • To present evidence supporting methadone's utility in acute and chronic pain.
  • To discuss perioperative pain management strategies for patients on methadone.

Main Methods:

  • Review of methadone's pharmacological actions, including μ-receptor agonism, serotonin/norepinephrine reuptake inhibition, and NMDA antagonism.
  • Examination of emerging clinical evidence for methadone in various pain conditions.
  • Analysis of perioperative pain management guidelines for patients receiving methadone.

Main Results:

  • Methadone acts as a potent μ-receptor agonist with a long half-life.
  • It modulates pain via serotonin, norepinephrine, and NMDA pathways, addressing hyperalgesia, allodynia, and neuropathic pain.
  • Evidence supports its benefits in perioperative, neuropathic, cancer, and non-cancer pain.

Conclusions:

  • Methadone possesses unique pharmacological properties beneficial for diverse pain types.
  • Its potential in acute and chronic pain management, including for opioid-naïve patients, warrants further investigation and clinical consideration.
  • Guidelines for surgical patients on methadone are crucial for safe and effective pain control.
Keywords:
NMDA antagonistacute and chronic pain managementmethadoneserotonin and norepinephrine uptake

More Related Videos

Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods09:29

Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods

Published on: August 4, 2022

2.3K
A General Method for Evaluating Deep Brain Stimulation Effects on Intravenous Methamphetamine Self-Administration09:16

A General Method for Evaluating Deep Brain Stimulation Effects on Intravenous Methamphetamine Self-Administration

Published on: January 22, 2016

15.4K

Related Concept Videos

Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
461
Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
849
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
401
Drug Abuse and Addiction: Pharmacological Phenomena01:15

Drug Abuse and Addiction: Pharmacological Phenomena

Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
766
Opioid Receptors: Overview01:22

Opioid Receptors: Overview

Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
2.1K
Drug Dependence01:17

Drug Dependence

Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
1.2K