In their first joint guideline effort, the American Pain Society and the American Academy of Pain Medicine developed and issued new guidelines for the treatment of chronic pain. The guidelines were published in the February issue of the Journal of Pain. A caution about methadone was included in the guidelines. Despite methadone being one of the most unpredictable opiods, it has become increasingly popular for treating chronic pain. Methadone’s effects are variable and it has been associated with arrhythmias and deaths. Among the recommendations for methadone are that patients be started on low doses and that methadone never be prescribed "as needed." According to the guideline writers, there is not enough research on the use of opiods for chronic non-cancer pain. Despite that, the methadone recommendation was one of the best supported amongst the guidelines.
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