Methadone: from Chronic Non-Oncological pain and primary Management Of Opioid Hyperalgesia to Disassuefaction Of Painkillers Abuse

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 AND RESULTS We conducted searches in PUBMED and MEDLINE for clinical trials and reviews done on the efficacy and safety of methadone used for analgesia in chronic pain and in the disassuefation from painkillers abuse. Clinical trials and the works found have overall shown that this drug has positive effects on the control of pain especially neuropathic and mixed and on some associated aspects such as the quality of life. 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.