Response phases in methadone treatment for chronic nonmalignant pain.

Full Abstract

Although studies on the beliefs of persons with chronic nonmalignant pain (CNMP) are still scarce, methadone is increasingly prescribed for the treatment of CNMP. This qualitative case study uses semistructured interviews to explore the beliefs of 11 patients with CNMP and the challenges they faced coming to terms with and integrating methadone treatment into their lives. The study identifies a two-phase process of acceptance and integration. In the first phase, during acceptance of the prescribed methadone treatment, initial beliefs were mostly determined by the societal stigma that "methadone is for junkies." Different influencing factors such as knowledge about methadone for pain management, family support, and trust in physicians changed behavior in a positive way. In the second phase, patients dealt with the degree of disclosure about their treatment. Full disclosers have no problem in telling others that they were being treated with methadone, whereas partial disclosers were more selective. They were confronted with various barriers: negative encounters with family, friends, and the public; past addict experiences; safety issues; and obstacles within the health care system. As a result of these challenges, their beliefs were summarized as: "others think I'm an addict," and "methadone can harm me and/or my family."This study highlights the important role nurses have in the education of patients on the use of methadone in pain management, and in assisting patients with CNMP to gain confidence and a greater sense of control to cope with the challenging issues related to disclosing information.

Author information

Author/s: Arnaert, Antonia (A); Ciccotosto, Gina (G);

Affiliation: McGill University, School of Nursing, Montreal, Quebec, Canada. Antonia.arnaert(-atsign-)mcgill.ca

Journal and publication information

Publication Type: Journal Article

Journal: Pain management nursing : official journal of the American Society of Pain Management Nurses (Pain Manag Nurs), published in United States. (Language: eng)

Reference: 2006-Mar; vol 7 (issue 1) : pp 23-30

Dates: Created 2006/02/21; Completed 2006/04/13; Revised 2007/11/15;

PMID: 16490733, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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