Members of the European Association for Palliative Care qualify for a discounted subscription. The use of methadone in the care of the dying Craig Gannon, Consultant in Palliative Medicine jointly at the Princess Alice Hospice, Esher, and the Spelthorne Palliative Care Team, UK Methadone is a synthetic opioid, chemically related to dipipanone, that has been available for 50 years. Methadone's actions are considered akin to morphine's with proven analgesic activity, but its acknowledged roles are the management of drug abuse and cough suppression. Methadone's pharmacokinetics require novel titration and extra care, but convey additional benefits. Methadone is regaining popularity as an analgesic, particularly for opioid rotation.
Fears surrounding methadone reflect an unbalanced focus on risks as opposed to benefits.
For patients suffering from this deterioration of their self-image, the decline of their bodies together with their physical dependence on others, produces feelings of shame. Key points For some patients, the deterioration in physical function, appearance and the lack of independence caused by a terminal disease may engender feelings of shame and humiliation. This may create severe problems with patients' experience of their body image and lead to great psychological distress. Body mediation therapies may help such patients to heal the psychological conflict that exists between the idealised body image and the experience of the actual body. However, such techniques should be used only with great care.