Opioid Use Disorder

What are the treatments?

Currently,  the best evidence supports medication assisted treatment with an opioid agonist like methadone or buprenorphine (which is available as a daily sublingual tablet/film or an extended release injection (once a  month), along with counselling.  For people who do not do well with either of these options, slow release oral morphine treatment is also available.

Detoxification can also be done, but has a high risk of relapse, and people are at high risk of overdose after detox, because they may use the same amount of opioid they did before they detoxed, but your body loses tolerance quickly to opiates (within a couple of days).

Opioid Agonist Therapy

In this type of treatment, the patient is prescribed a substitution  medication such as methadone or buprenorphine, so that they can reduce the harm of opiate use to their bodies and lives. 

Some people are concerned that this treatment means they are trading "one addiction for another". Although all opiates make you physically dependent on them, having a steady dose of opiate in your body instead of the rapid ups and downs of using short acting opiates helps keep a  person level. Also, because you no longer need to look for opiates, or try to find the money for them, or hide what you are doing, or try to cover up recovering from their effects, you really can go return to a fulfilling life of recovery. Really, it is similar to having diabetes. Some people with diabetes need to be on medication. This is not an issue of willpower -  they need the medicine to continue to live their lives. 

How do I know what treatment is best for me?

This depends on a lot of things - including how each medication makes you feel, whether you can access the pharmacy regularly or not, how you pay for your medication, and what other health issues you may have. 

What if I also have pain?

Both methadone and buprenorphine are very good pain medications.  Some people worry about the naloxone component in Suboxone (the trade name for buprenorphine/naloxone in Canada). Naloxone is NOT absorbed by mouth. It was added to prevent people from injecting it. If you inject naloxone, it produces a rapid withdrawal effect. But you do not need to  worry about that if you are taking the medication as prescribed, under your tongue. 

Treatment in Saskatchewan is a bit fragmented - please see this page from the Government of Saskatchewan on where you can access services. Dr Holowaty can also prescribe this medication for patients accepted in her practice.