Killing pain safely

RE "METHADONE is successful as painkiller, but can be deadly" (Page A2, Aug. 17): To provide effective, safe medical treatments, including pain management with oral methadone, healthcare providers need sufficient training, and patients and families need to be well informed of the risks and benefits of the therapy. The use of oral methadone by physicians without adequate training in pain management or palliative care places unacceptable risks on patients suffering with pain. However, federally mandated education of providers on the unique and variable pharmacological properties of methadone will likely be inadequate and could limit access to patients who may benefit from this therapy. Clinical mentoring in training programs is more likely to result in behavioral change and safe prescribing practices. Healthcare institutions and professional medical and nursing associations should take the first steps in addressing this public health concern.

Dr. CRAIG BLINDERMAN
Brookline
The writer is codirector of the Cancer Pain Clinic at Massachusetts General Hospital.