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To the Editor:
In this study,1 methadone was used by 41% of patients during opioid treatment. Methadone has activity at three different sites: agonistic activity at the mu opioid receptor,2 antagonistic activity at the NMDA receptor,3 and inhibitory activity on monoamine re-uptake.4 These latter two actions are not shared by morphine or by other commonly used opioids, such as oxycodone and fentanyl. Methadone’s antagonistic activity at the NMDA receptor may result in analgesia against neuropathic pain and other chronic pain states.5 In addition, the opioid agonist spectrum of methadone is different compared with morphine.6 Over the last few years, pain management experts have rediscovered methadone as a …
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