From the Research
Methadone can cause ototoxicity, as evidenced by recent studies, and patients taking this medication should be monitored for early signs of hearing problems. The most recent and highest quality study, published in 2020 1, suggests that opioid-associated ototoxicity, including that caused by methadone, may be a hypoxia-independent adverse effect and can occur with a wide array of opioids, supporting an opioid receptor-mediated mechanism.
Key Points to Consider
- Methadone-induced ototoxicity is considered a rare side effect, but patients taking higher doses or for extended periods may be at increased risk 2, 3.
- The mechanism behind methadone-induced ototoxicity likely involves damage to the cochlear hair cells or interference with neurotransmission in the auditory pathway.
- Patients on methadone maintenance therapy should be monitored for early signs of hearing problems, such as difficulty understanding speech, persistent ringing in the ears, or balance issues.
- Individuals with pre-existing hearing problems or those taking other potentially ototoxic medications may be at higher risk and should be monitored more closely.
- Regular hearing assessments may be beneficial for long-term methadone users to detect any gradual hearing changes before they become severe, as highlighted in a review on ototoxicity management 4.
Clinical Implications
- Healthcare providers should consider the potential for ototoxicity when prescribing methadone, especially in patients with risk factors for hearing loss.
- Monitoring for ototoxicity should be part of the standard care for patients on methadone maintenance therapy, as suggested by studies on drug-induced hearing loss 5.
- Early detection and intervention can help prevent permanent hearing damage and improve patient outcomes.