The need to address increasing opioid use in elderly COPD patients

Methadone has several unique characteristics that make it an attractive option for pain relief in serious illness, but the safety of methadone has been called into question after reports of a disproportionate increase in opioid-induced deaths in recent years. The American Pain Society, College on Problems of Drug Dependence, and the Heart Rhythm Society collaborated to issue guidelines on best practices to maximize methadone safety and efficacy, but guidelines for the end-of-life scenario have not yet been developed. A panel of 15 interprofessional hospice and palliative care experts from the U.S. and Canada convened in February 2015 to evaluate the American Pain Society methadone recommendations for applicability in the hospice and palliative care setting. The goal was to develop guidelines for safe and effective management of methadone therapy in hospice and palliative care. This article represents the consensus opinion of the hospice and palliative care experts for methadone use at end of life, including guidance on appropriate candidates for methadone, detail in dosing, titration, and monitoring of patients' response to methadone therapy.

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Safe and Appropriate Use of Methadone in Hospice and Palliative Care: Expert Consensus White Paper

McPherson

Walker

Davis

et al. 2019

Journal of Pain and Symptom Management

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The New “Opioid Crisis”: Scientific Bias, Media Attention, and Potential Harms for Patients with Refractory Dyspnea

Rocker

Bourbeau

Downar

2018

Journal of Palliative Medicine

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Prevalence of Pain in COPD Patients and Associated Factors

Miguel-Díez

López‐de‐Andrés

Hernández‐Barrera

et al. 2018

The Clinical Journal of Pain

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The need to address increasing opioid use in elderly COPD patients

Cited by 5 publications

References 21 publications

Safe and Appropriate Use of Methadone in Hospice and Palliative Care: Expert Consensus White Paper

Safe and Appropriate Use of Methadone in Hospice and Palliative Care: Expert Consensus White Paper

The New “Opioid Crisis”: Scientific Bias, Media Attention, and Potential Harms for Patients with Refractory Dyspnea

Prevalence of Pain in COPD Patients and Associated Factors

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