Dependency and Addiction Treatment

OPIOID SUBSTITUTION THERAPY (OST)

METHADONE MANAGEMENT THERAPY (MMT)

CHRONIC PAIN MANAGEMENT

OST / MMT FUNCTIONS

Methadone is substitution therapy for opioid dependent patients, whether they become dependent by legal prescription or by illicit street drug use.

Opioids include codeine, morphine, oxycodone, hydromorphone, heroin, fentanyl, etc.

Opioids are often effective for acute pain, both physical and mental. However if patients take opioids for too long and / or in larger quantities than needed, many become opioid dependent. For these patients methadone can be effective.

Opioids can also cause pain (eg codeine causing headaches, stronger opioids causing Opioid Induced Hyperalgesia, often called fibromyalgia).

In contrast to other opioids, once methadone reaches stable dose there is no need to progressively increase the dose.

In general the programme lasts at least two years.

The intent is to go on methadone maintenance and discontinue other opioids.

Methadone is not used for stimulants like crystal meth, amphetamine, Ritalin, and cocaine.

REGULATIONS

Methadone is highly regulated, both by Federal and Provincial laws, by the Colleges of Physicians and Surgeons in every Province and Territory, by standards and guidelines, and by the clinics and pharmacies, with rules we all have to follow.

THE PROCESS

Patients need a referral by a General Practitioner / Family Physician. Our staff will need name, Sask Health Card Number, Date of Birth, and a phone number to call to with the next available appointment. The first visit can last about an hour, and includes a history, examination, lab tests and urine toxicology. Other chronic conditions will also be assessed but patients are asked to continue seeing their regular physician for general care. If the diagnosis is opioid dependency the patient may be offered substitution therapy with methadone or buprenorphine.

CHRONIC PAIN

Most patients referred with chronic pain are already on long term opioids. In many cases methadone is effective for these patients too.

LINKS

Sask College of Physicians & Surgeons
Navigate to Programs and Services, then Methadone Program
The methadone Standards and Guidelines