Methadone is a substitution therapy for the treatment of the physiological and psychological dependence (aka “addiction”) to opioid class drugs such as Oxycontin, codeine, Percocet, Dilaudid, morphine and heroin. It is recommended that methadone medication be paired with other forms of addictions treatment including counselling (1:1 or 12 Step) and/or entry into in/out patient treatment programs.
For those who are opioid tolerant, methadone is a long acting opioid that can prevent the symptoms of physical withdrawal for 24 hours with one daily dose without the recipient ever feeling intoxicated, “high” or sedated. Treatment goals are individualized meaning that we support those practicing harm reduction as well as those focused on sobriety.
Methadone is taken daily in liquid form, mixed with juice, to discourage injection as a route of administration. Methadone is covered by Ontario Works, ODSP, Trillium and other forms of drug coverage. When a client does not have insurance coverage, methadone can cost anywhere from $5.00 – $7.00 per day in pharmacy dispensing fees.
What is buprenorphine/naloxone Substitution Therapy?
Buprenorphine/naloxone combines buprenorphine and naloxone to treat physiological and psychological opioid dependence.
It is a partial opiate agonist whereas methadone is a full opiate agonist. Suboxone is a medication intended to be taken sublingually – it comes in pill form and dissolves under the tongue.
Naloxone is added to discourage abuse, just as juice is added to methadone. When buprenorphine/naloxone is misused it can cause withdrawal symptoms.
An advantage to buprenorphine/naloxone is that, at the correct dosage, it can prevent physical withdrawal symptoms for up to 36 hours. A disadvantage to buprenorphine/naloxone is that it’s not currently covered by Ontario works, ODSP or the Trillium drug benefits program. The cost to the client varies.
Benefits of Methadone/ buprenorphine/naloxone Treatment
- When prescribed by a physician in a treatment program, Methadone/ buprenorphine/naloxone is legal. One dose can prevent withdrawal symptoms and cravings for up to 36 hours, preventing the need to access opioids by other means;
- Prescribed use of Methadone/ buprenorphine/naloxone is safer than snorting or injecting other opioids. It’s exact potency is always known when prescribed;
- Methadone is affordable and covered by many drug plans including OW, ODSP and the Trillium Drug Plan;
- Methadone/ buprenorphine/naloxone can eliminate the need to participate in the high risk behaviours associated with a drug seeking lifestyle, resulting in less chance of legal and/or negative social repercussions;
- Participation in the Methadone/ buprenorphine/naloxone program means continued attendance to a Change Health Care clinic which presents the opportunity for case management services and referrals to adjunct community programs;
- People participating in the program experience a decline in the use of needles, reducing the incidence of blood borne diseases such as Hepatitis C or HIV;
Most importantly, Methadone/ buprenorphine/naloxone allows opioid dependent people to focus on alternatives to daily drug abuse such as school, work and family.