Also known as “opiates,” opioids are drugs with powerful pain-relieving properties. When prescribed by a doctor and used responsibly, opioids can reduce pain and treat other symptoms. If they are over-used, opioids can change the way the brain works, causing the dependence and strong cravings that lead to opioid use disorder. Natural opioids (Morphine, Codeine, Opium, etc.) are substances that are derived from the opium poppy while semi-synthetic opioids (OxyContin, Hydromorph Contin, Dilaudid, Percocet, Heroin, Fentanyl, etc.) are produced in a laboratory from natural opioids. Synthetic opioids (Fentanyl, Methadone, Demerol, etc.) are manufactured in a laboratory. The following are some of the opioids being used now:
- OxyContin: OxyContin is a time-released, 12 hour pain medication for people who need around-the-clock pain relief.
- OxyNeo: OxyNeo is the new form of OxyContin that was brought in to curb abuse of the original drug. It can still be broken down and used to get high fairly easily.
- Percocet: Percocet is similar to OxyContin, but only lasts about five hours. It contains Oxycodone and Acetaminophen (the drug in Tylenol), which makes people sick if they take too much.
- Fentanyl: Fentanyl is most commonly available as a skin patch, but can appear in the form of lozenges, pills, shots and even a film that dissolves in your mouth. Used to treat extreme pain, and often for cancer, Fentanyl patches are often chopped up and put inside the mouth, or smoked and injected.
- Morphine: Morphine is a common medium to strong painkiller, often used after surgery.
- Hydromorphone: Hydromorphone or Hydromorphs are more often abused because Oxycodone is harder to obtain.
- Carfentanyl: Carfentanyl is an analog of Fentanyl. It is 10,000 times more potent than Morphine, making it one of the most potent and dangerous opioids.
Addiction is a term used to describe a range of compulsive behaviours and is characterized by behaviours that include one of more of the following four C's:
- Compulsion to use
- Control - a loss of control over drug use
- Cravings - a preoccupation with use
- Consequences - continued use despite knowledge of harmful consequences
People with addictions are not weak and it is often not their fault, there are many genetic and environmental factors that play a huge role in deciding who will and will not become an addict. At Segue Clinic, we believe that opioid addiction is a chronic disease much like asthma, diabetes, or heart disease with a 40% relapse rate. It’s best treated by facilitating change, committing to abstinence and encouraging recovery. The majority of people we help choose this approach.
We also understand that some people are not yet ready to completely stop their drug use. If this is your situation, we will suggest the “harm-reduction” approach, focusing on helping you be healthier by preventing or reducing opioid-related harm rather than trying to prevent you from using opioids at all.
Medication assisted treatment is the use of medications to treat your addiction. This is often the best way to combat opioid addiction, especially with the addition of counselling, and can also be highly effective in treating alcohol addiction and other substance use disorders. The medications we most often prescribe for this treatment are Suboxone and Methadone.
- An initial intake interview to decide if this approach is the best treatment for you.
- An initial medical examination and laboratory tests.
- Drug testing of your urine so we can monitor your progress and your compliance with our program.
- Addiction counselling and ongoing medical assessments.
- Connection to appropriate community resources.
You’ll be treated by physicians who are certified in Opioid Dependence Treatment using both Methadone and Suboxone.
Your care will also be provided by staff thoroughly trained in all aspects of Opioid Dependence Treatment.
Segue Clinic provides services that extend beyond the treatment of opioid addiction:
Connections to partner counselling services, including Smart Recovery and 12 Step programs.
Referrals to residential treatment facilities, mental health care and family physicians.
Referrals to parenting classes, prenatal health care and social agencies.
Help with completing forms for drug plans, social assistance, dietary needs and housing.
Research proves that the most successful treatment of opioid dependence involves a combination of medical management using Suboxone or Methadone and counselling. While the medication works to reduce your cravings, a counsellor will teach you techniques to help you change unhealthy habits that have developed as a result of your addiction. Therapy can also help you rebuild relationships and return to your family responsibilities and will offer you the support you need to make meaningful life changes. This powerful combination of counselling and medical management is what we believe will work best to help you achieve and maintain remission from your opioid dependency.
The unfortunate reality is that relapse can be part of the disease. Instead of terminating your participation, we take a proactive approach to help you get back on track. We increase your Segue Clinic visits and we expand your counselling support. We will be there when you need us most.
If a medical, dental or surgical procedure makes treatment with opioids necessary, we will work with your physician or other health care providers. Together, we will ensure that your Suboxone/Methadone doses are appropriate in combination with medications for pain relief.
All physician services and urine tests are covered by the Ontario Health Insurance Program (OHIP). Out-of-province patients are covered by their individual provincial health plans (excluding Quebec).
The cost of methadone is covered by the Ontario Drug Benefit Program for those patients who are covered by that plan. Otherwise, there may be costs for the medication and/or dispensing at your pharmacy.
Suboxone is usually covered by private drug plans and special coverage may be available through the Ministry of Health’s special consideration department.