Which of the following is TRUE about methadone dosing?

When it comes to methadone dosing, the statement about reducing the equianalgesic dose by 80-90% when switching to methadone from other opioids is grounded in clinical practice and safety. This recommendation is based on the unique pharmacokinetics of methadone and the risk of overdose that can occur due to its long half-life and incomplete cross-tolerance when transitioning from different opioid medications.

Methadone's effectiveness can be influenced by its genetic metabolism, leading to variability in how patients respond compared to other opioids. Therefore, beginning with a lower dose helps mitigate the risk of respiratory depression and other adverse effects as the patient adjusts to methadone therapy. This cautious approach is particularly important given the opioid overdose epidemic and the critical need for safe and effective treatment protocols.

In contrast, increasing the dose when switching from other opioids might not take into account the complexities of cross-tolerance that can lead to serious complications. Methadone does not have the same effect as other opioids due to these unique properties and its method of action on the body’s opioid receptors. Additionally, it certainly does carry a risk of respiratory depression, similar to other opioids, especially at higher doses, thus emphasizing the importance of careful