Methadone treatment

Ann Mullens' account of the initiative by the College of Physicians and Surgeons of British Columbia to expand its methadone program clearly illustrates the need for better facilities for opioid addicts.1 However, the wider debate about methadone should also incorporate the fact that methadone is a tried and tested drug for the treatment of chronic pain and for pain in terminal illness. It is cheap, long lasting and well absorbed when taken orally. However, many pain and palliative care specialists hesitate to prescribe this useful drug because, without a permit, the referring physician is usually unable to continue therapy.

No one would argue against making sure that those who care for people addicted to opioids have the necessary training and experience. Restricting physicians' ability to prescribe methadone may achieve this, but it places an extra administrative burden on those who care for those with intractable pain or who are near death.