By the British Columbia Centre on Substance Use

If you are reading this handbook, then you, or someone you know, may need help to deal with opioid use disorder – a situation where you need to keep using heroin, fentanyl, or similar opioids because you feel physically sick if you don’t have them. Taking more opioid drugs will stop the pain, but over time, your body may need more to get the same effect.

This handbook talks about opioid agonist treatment (OAT) – including buprenorphine/naloxone (brand name Suboxone®), methadone (brand name MethadoseTM or Metadol-D®), slow-release oral morphine (brand name Kadian®), and injectable treatment options (hydromorphone or Dilaudid® and diacetylmorphine or prescription heroin). These medications are also opioids, but they provide stable, long-acting relief from withdrawal and cravings. They replace the street heroin or fentanyl that you or someone you know are taking with a regular dose of a medication that allows for a stable life.

A lot has changed since the first edition of this handbook came out in early 2017, so it has been updated and re-written to share all the new things we know about treating opioid use disorder and saving lives. In the past, methadone was the main medication prescribed to people with opioid use disorder (sometimes called opioid dependence or opioid addiction). However, harsh government policies existed that made it hard for doctors to prescribe it. Now, more OAT options are being scaled up and barriers to access are being removed (including barriers to accessing different types of methadone). Policies are changing to increase people’s access to these medications. More people can make choices in their drug use that don’t involve using street drugs that might be contaminated.

Throughout this handbook, OAT options may be referred to by their brand names (for example, Suboxone) or their generic name (for example, methadone), depending on which name is more commonly known. However, even though we might use specific brand names in this guide, we do not represent or endorse any pharmaceutical companies.

This resource sets out to answer some of the common questions that people have when they need help in dealing with opioid use or opioid dependence.