OPIATE REPLACEMENT THERAPY
There are two legal medical treatments available that effectively manage opiate dependency: methadone and Suboxone. Both treatments offer long-acting effects that aid in battling withdrawal symptoms and reducing cravings.
No matter what treatment you and your doctor choose to work with, we will be here every step along the way to make sure you feel that it is best for you.
Below are listed the main differences between the two treatment options:
DRUG OF
CHOICE
Any opiate.
This can include heroin, Fentanyl, morphine, Hydromorphone, codeine, Percocets, oxycodone etc.
METHADONE
SUBOXONE
HOW DO
I BEGIN TREATMENT?
METHADONE
No referral needed from another physician.
The doctor will assess your use and individual case.
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After assessment, the doctor will determine whether or not you can safely start that day. If you can, they will give you a low starting dose. After a minimum of three days in a row of dosing, you may be reassessed to receive a dose increase to gradually build up to the dose that will keep you comfortable.
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It may take weeks to reach a fully effective dose.
No referral needed from another physician.
The doctor will assess your use and individual case.
After assessment, the doctor will give you specific information for you to prepare for a Suboxone start. The doctor will determine the length of time that you will need to be clear of opiates to safely start Suboxone without having precipitated withdrawal.
You will be given an initial test dose after being evaluated by the doctor and after 1-2 hours you may get a follow up dose depending on your symptoms.
Often people are able to feel better the same day they start.
A fully effective dose can be reached in days.
A fully effective dose is one where feel no withdrawal symptoms throughout the day.
FORM
Methadone is a liquid solution. Your dose is pumped into a disposable cup and then mixed with juice.
An orally disintegrating tablet placed under the tongue.
Suboxone comes in either 8mg or 2mg tablets.
It is made up of two active ingredients:
buprenorphine and naloxone.
Buprenorphine replaces the opiate.
Naloxone blocks other intravenous opiate use.
WHAT DOES
IT DO?
COST
If you are on Ontario Works (OW), Ontario Disability Support Program (ODSP), or are under 25 or over 65, Suboxone will be covered a government plan. If you are covered through a private plan, you may be eligible to be covered for Suboxone treatment.
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If you are paying cash, the generic tablets can be as low as
$4 for the 2mg tablet and $6 for the 8mg tablet.
The brand-name tablets start at around
$6 for the 2mg tablet and $8 for the 8mg tablet.
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Eliminates withdrawal symptoms and reduces the craving for opiates.
It also reduces the risk of overdose as methadone blocks the opiate.
Eliminates withdrawal symptoms and reduces the craving for opiates.
It also reduces the risk of overdose as Suboxone blocks the opiate.
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If you are on Ontario Works (OW), Ontario Disability Support Program (ODSP), or are under 25 or over 65, methadone will be covered a government plan. If you are covered through a private plan, you may be eligible to be covered for methadone treatment.
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If you are paying cash, the cost is within the $5-7.50 range per dose depending on the pharmacy.
SIDE
EFFECTS
Dry mouth is a common side effect, attention to mouth moisture and dental hygiene are important to avoid tooth decay. Sedation, reduced libido, sweating, and weight gain are also possible.
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Methadone, particularly if taken irregularly or in larger quantities than intended can cause respiratory depression and toxicity. The risks are highest in the first four weeks on treatment.
The side effects are usually much less pronounced than to methadone. There are also less dangerous interactions with other medications.
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Suboxone has less risk of respiratory depression and toxicity.
With both forms of treatment, you will have to visit a pharmacy and receive the prescribed dose each day. Your doctor will want to see you at least once a week and have you submit regular urine tests in order to ensure that you are receiving a dose that works well for you.