Introduction

Methadone maintenance treatment (MMT) is recognized, in Canada and internationally, as an effective, safe and cost-effective treatment option for opioid1 dependence. Although other forms of treatment continue to be explored, MMT remains the most widely used form of treatment for people who are dependent on opioids (Health Canada, 2002a). MMT can decrease the high cost of opioid dependence to individuals, their families and society (World Health Organization, 2004). Despite the research supporting MMT, public scepticism and myths about this form of treatment persist (Bell & Zador, 2000).

In its 2007 report, the Methadone Maintenance Treatment Practices Task Force recommended that the Ontario government improve access to MMT. The task force identified public resistance as a barrier to sustained access to MMT services, and recommended greater awareness of MMT and more intensive engagement of communities in the development of MMT services.

CAMH’s Opiate Awareness, Treatment and Education (OpiATE) project is supported by funding from the Ontario Ministry of Health and Long-Term Care and is in partnership with the College of Physicians and Surgeons of Ontario (CPSO), Registered Nurses’ Association of Ontario (RNAO) and the Ontario Pharmacists’ Association (OPA). The OpiATE project addresses the issues of opioid dependence in a way that builds on the work of the Methadone Maintenance Treatment Practices Task Force’s report. CAMH believes that increased awareness and community engagement, along with professional supports, are critical in the development of an effective provincial response to the task force’s recommendation. It is this commitment that led to the revision of this guide.

opiate (n., adj.) naturally occurring substances—including morphine and codeine—found in opium (an extract from the seed pods of the opium poppy, Papaver somniferum L.). The term also refers to semi-synthetic opiate derivatives such as heroin and oxycodone. The term opiates is often incorrectly used to refer to all drugs with opium/morphine-like qualities, which are more properly classified under the broader term opioids.

opioid (n., adj.) any agent that binds to opioid receptors found in the brain and central nervous system. The four classes of opioids include: those naturally produced in the body (e.g., endorphins); opiates derived from opium (e.g., morphine, codeine); semi-synthetic opioids such as heroin and oxycodone; and fully synthetic opioids such as methadone that have structures unrelated to the natural opiates.

Reprinted with permission from the User Guide for working with the documentary Prescription for Addiction (2008).

In Methadone Maintenance Treatment: A Community Planning Guide

Acknowledgements

Introduction