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Methadone Maintenance Treatment: Best Practices in Case Management 


In our lives, every one of us experiences times when we struggle with a problem or crisis and need help. Often, the struggle to figure out where to get the appropriate help makes our lives even more difficult and can complicate the problem.

When people are faced with the challenge of dependence on drugs that alters their ability to think clearly or even to manage basic daily functions, the additional tasks associated with finding help can be daunting. Providing support for these tasks—the essence of case management—is often an important part of a successful recovery. More from the Forward...

Please note: In the process of posting this CAMH publication online, links to external sites were reviewed. In those cases where links have changed or are no longer in use, they have been deleted from the HTML (web page) version, but remain in the PDF versions. As a result, not all web pages will exactly match their PDF and print counterparts. The PDF versions will be updated if and when the print version is updated. We apologize for any inconvenience.


Members of the Working Advisory Panel

Section I: Background

Section II: Recommendations and Discussion

Section III: Beyond the Recommendations

Appendix A: Other issues

  • Methadone for chronic pain management
  • Withdrawal management and detoxification
  • Buprenorphine treatment

Appendix B: Resources

  • For clients and other members of the public
  • For everyone interested in MMT
  • Other resources for case managers

Forward continued

This book is important because it guides those whose job it is to help others get the help they need. It is the first evidence-based guide written specifically for case managers working in methadone maintenance treatment in Ontario.

The role of a methadone case manager is complex, requiring skills in counselling and communication; a large body of knowledge about drug use, health and social problems; and knowledge about the many potential agencies and organizations for referral.

This guide is therefore a valuable tool, both for case managers and for the organizations that employ them. In the course of recommending best practice guidelines, it provides an opportunity for case managers to reflect upon how they might enhance the way they interact with their clients. The scenarios, practice points and practice perspectives could be used to stimulate discussion in staff meetings. For organizations, the description of the core of knowledge required can both facilitate hiring the appropriate staff and provide a framework for a training plan for existing staff. And although its recommendations are about case management best practices in methadone maintenance treatment programs specifically, the guide’s practical focus also makes it useful and interesting to other case managers working in addictions or mental health.

This book may also assist planners and funders in addressing opioid addiction and methadone treatment with a comprehensive, client-centred perspective within a co-ordinated system approach. It speaks to the importance of addressing our knowledge and attitudes about the people who need support—and to the kinds of support they want.

The guide includes the voices of the people who are best able to describe the services that will help them stabilize their lives. These voices evaluate the services they receive and tell us first-hand the importance of providing accessible service and support.

Opioid addiction is on the rise (in Ontario, the majority of people who use opioids are using prescription medications), and methadone maintenance is a medically recognized treatment for it. Many of those who take methadone state clearly that case management is an essential service that complements their medical treatment. Readers of this book will learn just how case management helps people achieve stability and health in their lives.

Christine Bois
OpiATE Project Manager
CAMH, Ottawa

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