(R)-methadone versus racemic methadone: what is best for patient care?

Methadone has been linked to cardiac arrhythmia. (R)-methadone appears to confer a lower risk of QT interval prolongation, resulting in debate over how best to treat patients needing this medication. A discussion of salient aspects of selecting therapy for opioid dependence and pain management and decision-making regarding methadone formulation follows.