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Opioid Agonist Treatment

Opioid agonist treatment, often called OAT, uses medications such as Suboxone and methadone to treat opioid addiction, reduce drug-related harms and support long-term recovery. 

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In light of the opioid overdose crisis our communities are facing today, working with government and other partners, we have invested in addiction prevention, treatment and recovery. Increasing access to opioid agonist treatment is a key priority in this work and in our opioid crisis response.

What is opioid agonist treatment?

Opioid agonist treatment is a safe and effective medication-based treatment for people who are dependent on opioid drugs such as heroin, oxycodone, hydromorphone (Dilaudid), fentanyl and Percocet.

The treatment helps clients and patients who live with opioid addiction improve their day-to-day functioning, find stability, manage withdrawal symptoms, and work toward recovery. It can lower the risk of drug-related harms, including hepatitis C and HIV transmission as well as fatal overdose. It can also help people stay in treatment and engage in their care.

How does opioid agonist treatment work?

Opioid agonist treatment involves taking opioid agonist medications such as methadone, buprenorphine/naloxone (Suboxone), or slow-release oral morphine (Kadian). These medications act slowly in the body, work to prevent withdrawal and reduce cravings for opioid drugs. These medications are prescribed in a structured, supervised clinical setting to ensure the patient or client's safety. 

Regardless of the type of medication provided, the treatment works best when combined with other types of support, including the following:

  • Counselling
  • Long-term substance use monitoring, such as regular assessment and urine drug tests
  • Harm reduction practices and education, such as Take Home Naloxone kits
  • Referrals to case management, relapse prevention supports and specialist care
  • Comprehensive preventive and primary care, such as yearly check-ups, screenings and immunizations

Our approach

We offer opioid agonist treatment to clients and patients at all of our sites, including the following:

Suboxone or methadone?

According to the Provincial Guidelines for treating opioid use disorders, buprenorphine/naloxone (Suboxone) is recommended as a first-line therapy, which means that it is the first medical treatment a health care professional might prescribe for someone living with opioid addiction. It is a partial opioid agonist and therefore has a lower risk of overdose, fewer and less severe effects, and a lower risk of drug interactions compared to full opioid agonists such as methadone.

Methadone is still a useful treatment option, especially if buprenorphine/naloxone makes one feel ill or is ineffective.

How do I access opioid agonist treatment?

Opioid agonist treatment services are typically prescribed by a doctor and accessed through pharmacies or residential or outpatient treatment programs. Some clients or patients may also require additional support to adhere to their medication regime.

If you are interested in starting or continuing this course of treatment, contact your doctor directly or find an opioid agonist treatment clinic in your area.

How long does treatment last?

The length of treatment will depend on the patient or client, and how much time they might need to deal with the emotional, physical and/or social issues that led to their opioid use in the first place. This may take as little as a few months or as much as several years — everyone's journey is different. Generally, long-term treatment (that is, greater than six months) is associated with better health outcomes.

What about detox?

Detox, also known as withdrawal management, alone is not an effective treatment for opioid use disorder. Research shows that most people who have stopped taking opioids without first being stabilized on opioid agonist therapy will lose their tolerance very quickly and relapse. This is very dangerous — if someone starts using substances at the same dosage they were previously used to, the risk of a fatal overdose is much higher.

If your patient or client is thinking about detox or chooses to skip stabilization, inform them of the harms and encourage a period of opioid agonist therapy or a slow taper with methadone or Suboxone. A pharmacist can help set a schedule of dose reductions with frequent follow-up.

Learn more about opioid agonist treatment

The B.C Centre on Substance Use offers an accredited Provincial Opioid Addiction Treatment Support Program online course, available free of charge. Although geared towards prescribers, all health care professionals involved in treating people with opioid use disorders would benefit from this training.

Substance Abuse and Mental Health Services Administration has many resources, programs and data available to help you learn more about prevention, treatment and recovery efforts. Their resource centre contains a collection of tool kits, manuals, clinical practice guidelines and other evidence-based resources for communities, clinicians, policy makers and others working in the field. 

SOURCE: Opioid Agonist Treatment ( )
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