Methadone sounds like an odd thing here off the top of my head, but a doctor I am not. What was the proffered rationale. Was it the best painkiller for that patient’s situation? Why not morphine?
Lots of “off label” use of all the opioids. If you’re up past dilaudid for pain you shouldnt be walking around in public. There are new and different delivery systems for them all as well and surprisingly microdosing of once thought heavy duty methadone works for things not imagined before the tech to produce them.
Benzos (Ativan, Xanax, Valium) are standard issue for patient compliance if insurance covers it because what Dr wants to work on a frustrated, worked up, short tempered asshole thats been in pain for the last 10 years? Especially when he hasnt been taking his addictive opioids like we want him to and refuses every antidepressant we have offered him.