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FAQs - General

Successful recovery from an OUD requires treatment. Like other illnesses such as diabetes and depression, OUD is caused by biological, psychological, and social factors, and just like these other illnesses, it is very hard to manage on your own. 

Unfortunately, people cannot talk themselves out of an illness. If you could, you would have done so already. Because OUDs involve your brain, your body, and other outside factors, getting better is not as simple as just “deciding.” However, the good news is that effective treatment is available. Medical treatment for addiction has been shown to work extremely well, better than treatments for many other medical problems. 

Your chances of recovery are greatly improved if you have had long periods of sobriety in the past, you have social supports, such as family and friends, and you are only addicted to opioids and not other drugs or alcohol. 

The side effects of methadone and buprenorphine are similar to those of other opioids: sedation and fatigue, drowsiness, constipation, sweating, nausea, and sexual dysfunction. Some of these side effects disappear over time. If you continue to experience side effects, you should speak to your health care provider about reducing the dose or using additional medications to relieve the symptoms. If you can’t tolerate the side effects, you should ask your health care provider about discontinuing the drug. 

Methadone and buprenorphine are very different from other opioids. When taken in the right dose, neither causes euphoria or intoxication. You also do not experience withdrawal symptoms and will not have to spend time and money acquiring these medications; all you need is a prescription from a doctor or nurse practitioner and access to a pharmacy.

Your health care provider will tell you how to taper the medication slowly and safely. This decreases the risk of going through withdrawal symptoms. If you have very strong urges, or if you relapse, you should go back on the medication. 

How long you stay on these medications is up to you. However, you are much less likely to relapse if you taper off these medications gradually once your life becomes more stable, and you haven’t used non- prescribed opioids for at least six months. In general, the longer you’ve been addicted to opioids, the longer you should stay on methadone or buprenorphine. You and your health care team should talk regularly about how the medication is working for you, if the dose needs to be altered, or if you are ready to discontinue it. 

Medications are sometimes started at your first medical appointment, and most options will start to reduce cravings in just a few days. Buprenorphine must be started while you are in withdrawal, or else it will trigger withdrawal symptoms. You and your health care provider can determine the right time to begin. 

Treatment programs have various waiting periods and assessment procedures. It is important to have a plan for staying sober until your program begins. 

You can start attending self-help groups right away. You can try several different groups to figure out which one works best for you.

Methadone is covered under Ontario Drug Benefits and most private plans. If you are paying out of pocket for methadone, the cost depends on your dose and the pharmacy’s dispensing fees; the usual cost is around $7 a dose. 

Generic buprenorphine is also covered under Ontario Drug Benefits and private plans; brand-name buprenorphine is 50% covered. 

No; in fact, your OUD is probably making your pain worse. This is because you go through withdrawal every day as the opioid wears off, and withdrawal greatly magnifies your perception of pain. Also, people with OUDs are often depressed and anxious because their addiction is making their life very difficult. Depression, like withdrawal, magnifies people’s sense of pain. If you treat your OUD, you will experience a decrease in your chronic pain as well as an improvement in your daily functioning. 

If you take high doses of opioids every day for several weeks or more, your nervous system changes in order to resist the drowsiness caused by opioids. This change is called tolerance. People who use opioids daily are often able to function normally even after taking amounts that would be fatal to someone who does not take opioids. When a heavy user suddenly stops using, the nervous system takes several days to return to normal. During this time period, people experience withdrawal. As the drug wears off, people begin to experience acute withdrawal, which is usually at its worst two or three days after last use. The physical symptoms of acute withdrawal are like a very bad case of the flu; people experience muscle aches, nausea and vomiting, cramps, chills, sweating, yawning, and goosebumps. In addition, people often experience psychological symptoms such as severe insomnia, anxiety, fatigue, and powerful cravings. These psychological symptoms are usually much more uncomfortable than the physical symptoms. Acute withdrawal is generally not medically dangerous, although it is extremely uncomfortable and distressing, and symptoms begin to get better five to seven days after last use. 

After acute withdrawal gets better, many people experience sub-acute withdrawal, whose symptoms include anxiety, insomnia, fatigue, and craving. Sub-acute withdrawal can last for weeks or even months, and there is a risk of relapse during this period. If you relapse while in sub-acute withdrawal, it is imperative that you do not take your regular amount of opioids. Your tolerance will not be as high as it was before, which means you are in danger of an overdose.

Starting a new treatment program can sometimes be overwhelming. You will be meeting with strangers and discussing things that are probably difficult to talk about. However, most people find that it is comforting to talk to people who understand what they are going through. Once you start your treatment, your fear and anxiety about attending will probably diminish within the first few days, and you’ll be happy and proud of yourself for sticking to it.

There is no one right treatment path for everyone. You and your health care team should discuss which treatment or combination of treatments would be helpful in your recovery. 

Your physician may offer you medication (such as clonidine and buprenorphine) to help relieve the symptoms of acute withdrawal. During sub-acute withdrawal, the most important things are to keep yourself out of situations where you might be tempted to use opioids, and to remind yourself that things will get better. 

If you do use opioids after even a few days of abstinence, you are at greater risk for overdose because your nervous system is losing its tolerance to opioids. Follow these guidelines in order to minimize your risk of an overdose: 

  • ∙ €Use much less than you did before you went through withdrawal. 
  • ∙ €Do not use intravenously; this delivers the opioids to the brain very quickly. 
  • ∙ €Do not use benzodiazepines, alcohol, or other sedating drugs while using opioids. 
  • ∙ €Never use alone. Always have a friend with you. 
  • ∙ €If a friend has taken opioids and is nodding off, call 911. 
  • ∙ €Never let someone who is nodding off fall asleep. 

You can tell your family that a health care provider has diagnosed you with an OUD. This illness, like many illnesses, is recognized by medical and mental health professionals as having a biological, social, and psychological component. You can explain to your family that it is not your fault that you have an OUD, but it is your responsibility to now get treatment. You should also tell them that their support is very important to your recovery. 

Beyond the medical treatments that you’ll discuss with your health care team, social support can be incredibly important in recovery. People who have recovered from OUDs often say that their family played a big part in their success. 

Even if your family is angry with you right now, they will begin to trust you again when they see that you are committed to your recovery. This can often take time, but eventually you will be able to rebuild relationships. Family members can also benefit from being included in your recovery. They may feel more involved in the process if you invite them to medical appointments and keep them updated on your progress. Some families also find it helpful to attend Nar-Anon meetings to be supported by other people going through similar experiences, and to access information on how to support loved ones going through treatment.

People with OUDs often have the following four traits:

(a) They cannot control their opioid use.

(b) They continue to use opioids despite knowing it is harmful.

(c) They spend a lot of time obtaining opioids, using opioids, and recovering from opioid use.

(d) They have powerful urges or cravings to use opioids. OUDs have nothing to do with character, will power, or morals. Many good and strong people have an alcohol or drug problem. People with OUDs find that once they start using opioids, it is no longer about choice.

Both medications are opioids and are taken once daily (methadone is mixed in fruit juice and buprenorphine is a tablet that dissolves under the tongue). Methadone is a full opioid. It tends to have more side effects than buprenorphine and it is more likely to cause overdose if taken in excess. Buprenorphine is a partial opioid, meaning that it has milder side effects for most people and is less likely to cause an overdose. However, some patients find that methadone is more effective at relieving withdrawal symptoms and cravings. Your health care team may wish to start you on buprenorphine and discuss switching to methadone if you find that the buprenorphine is not relieving your cravings.

You have been diagnosed with this disorder because you have repeatedly tried but have been unable to cut down or stop your opioid use. People with OUDs have lost control over their use, and regularly consume more than they intend to despite knowing that it’s harmful to them. This happens to certain people because of the biological, social, and psychological reasons discussed above.

FAQs - Our Opioid Addiction Program

You will work through your treatment plan with your physician.  Based on the treatment you need, you may (or may not) require to see your physician in person.  You would know this ahead of time, and we would plan it to work within your schedule.

Your physician may require you to go to a lab for blood work or for a urine sample.  Don’t worry, we can set this up very discretely.  You can go to any lab; we will either email you a requisition or send it directly to the lab of your choice.

We can send the prescription to a pharmacy of your choice.  We can also have your prescription delivered right to your home.

Don’t worry, as long as you have a phone number we will call you right back to finish your appointment by telephone.

FAQs - Our Alcohol Addiction Program

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