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Patients Helping Patients Understand Opioid Substitution Treatment


Author: Canadian Institute for Substance Use Research


Since you are reading this booklet, we assume you are looking for help for opioid dependence—addiction to heroin, fentanyl, oxycodone or any number of other pills. Or maybe someone close to you needs this help. This booklet talks about opioid substitution treatment (OST)—medication-assisted treatment with methadone or Suboxone (buprenorphine/naloxone). These medications are also opioids, but they provide stable, long-acting relief from withdrawal and cravings. They replace the heroin or fentanyl that is causing the problem with a regular dose of a medication that allows for a stable life.

This handbook has been written by a group of patients in British Columbia. We all have long experience with medication-assisted treatments for opioid dependence.

Deciding to seek help is an important step in any process of recovery. You are making a wise decision to seek help now. People dependent on opioid drugs and not receiving opioid substitution treatment (OST) are many times more likely to die or be seriously harmed by problem drug use.

We know that treating an addiction is not as simple as fixing a broken leg. Addiction is a complex social issue often with factors reaching back into early childhood. Successful treatment involves helping you take control of your own life. You need determination, and some specific goals that you are trying to achieve. Doctors, nurses and counsellors can help you identify your goals and support you in getting the tools you need. But much of the work has to be done by you, the patient.

This handbook sets out to answer some of the common questions that people have when they need help in dealing with opioids. We hope it is helpful.

What's inside

  • Introduction to the handbook

    • Brief History of OST in British Columbia

    • How does OST work?

  • Preparing for OST

    • Who should consider OST?

    • What are the treatment options?

    • What about side effects?

    • How do I get started?

    • How long will I be on OST?

    • What are my rights and responsibilities?

    • What fees and other costs may be involved?

  • Managing OST

    • Overview of a new routine

    • Your relationship with your doctor

    • Your relationship with your pharmacist

    • Overdoses and naloxone (Narcan)

    • Your supports and services

  • Getting off OST

    • Making the decision

    • Developing a plan

    • Implementing the plan

    • Reassessing

  • Frequently asked questions

    • Can I get my treatment in the hospital?

    • Can I get my treatment in jail?

    • What if I use other drugs while on OST?

    • What if I’m pregnant?

    • Why is naloxone added in Suboxone?

    • What if I’m HIV/hep C positive?

    • Can I travel while I’m on OST?

    • How do I make a complaint?

    • Tips for dealing with stigma

  • Glossary of terms

  • Notes

patients helping patients cover


About the author

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The Canadian Institute for Substance Use Research, formerly CARBC, is a member of the BC Partners for Mental Health and Addictions Information. The institute is dedicated to the study of substance use in support of community-wide efforts aimed at providing all people with access to healthier lives, whether using substances or not. For more, visit


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