Can I Use Methadone to Wean Pain Patients From Opioids?
Dear DEA I am writing to request clarification of the regulations regarding the weaning of opioids from patients who are physically dependent on them. I treat a number of patients who have failed to respond to moderate- to high-dose opioid therapy, and I direct a program in which their current opioid is replaced with another, which is then weaned. Our hospital pharmacy has declined to provide methadone for this purpose, out of the belief that I am performing methadone detoxification, which of course requires special registration. The pharmacy also questioned the legality of my practice of weaning these patients by replacing their usual opioid analgesic with a tapering dose of controlled-released morphine. My understanding has been that the detoxification of patients with the disease of narcotic addiction was legally distinguished from the weaning of opioids in pain patients, but I now need to know this with more certainty. I would like to thank you in advance for attention to this matter.
