The prevalence of constipation in patients receiving methadone maintenance treatment for opioid dependency

Abstract

Constipation is a recognized adverse effect of strong opioids. Unlike patients receiving strong opioids for the relief of cancer pain, patients receiving methadone maintenance therapy for opioid addiction do not always appear to be routinely prescribed laxatives or have their symptoms of constipation assessed. This survey shows that in patients receiving methadone maintenance treatment symptoms of constipation were pronounced in 26% of patients surveyed. Interestingly, 29% of patients reported minimal or no symptoms of constipation. None of the patients at the start of the survey was co‐prescribed laxatives. We believe this study suggests that clinicians involved in prescribing for methadone maintenance programmes should routinely enquire about symptoms of constipation and treat as appropriate. This study also indicates that patients receiving methadone may develop a varying degree of tolerance to the constipating effects of strong opioids—a finding previously illustrated in cancer patients receiving strong opioids.

• Constipation
• methadone maintenance
• opioid dependency

Acknowledgements

The authors thank Professor S. McMillan for allowing the use of the Constipation Assessment Scale.