Mullins Cormac F, Walsh Sarah, Fitzgerald Joseph
Department of Pain Medicine, South Infirmary Victoria University Hospital, Cork, Ireland.
Department of Anaesthesiology and Pain Medicine, Cork University Hospital, Cork, Ireland.
Pain Manag. 2025 Apr;15(4):191-198. doi: 10.1080/17581869.2025.2479411. Epub 2025 Mar 31.
The management of patients on chronic methadone therapy for opioid use disorder presents unique pharmacological and psychosocial challenges in hospital settings. This case series discusses complexities such as methadone's variable pharmacokinetics, alternatives to oral methadone and conversion ratios. Additionally, it outlines the nuances around the psychosocial considerations of methadone therapy and addressing addiction-related behaviors without compromising patient dignity. The review calls for individualized care plans with uninterrupted opioid agonist therapy to meet the baseline opioid requirements and pro-active pain management plans. Enhanced clinician education and better real-world data to guide methadone management is important to improve outcomes for this vulnerable patient cohort.
在医院环境中，对患有阿片类药物使用障碍且接受慢性美沙酮治疗的患者进行管理，会带来独特的药理学和心理社会挑战。本病例系列讨论了诸如美沙酮可变的药代动力学、口服美沙酮的替代方法和转换率等复杂性问题。此外，它还概述了美沙酮治疗心理社会考量方面的细微差别，以及在不损害患者尊严的情况下处理成瘾相关行为的方法。该综述呼吁制定个性化护理计划，采用不间断的阿片类激动剂治疗以满足基线阿片类药物需求，并制定积极的疼痛管理计划。加强临床医生教育和获取更好的真实世界数据以指导美沙酮管理，对于改善这一脆弱患者群体的治疗效果非常重要。
