Substitution Treatment
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Is substitution treatment right for me?
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How do I deal with stigma?
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Can I go on substitution if I’m pregnant?
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How does substitution treatment work?
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What are my treatment options?
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What about side effects?
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How do I start substitution treatment?
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What are the costs?
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Should I get other support too?
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Can I stop taking the medication?
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What are some myths?
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Substitution Quiz
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Frequently Asked Questions (FAQ)
How do I start substitution treatment?
1. Go See a Doctor
It’s important to find the right doctor for you; not every doctor is able to prescribe the medications you might need for substitution treatment. For methadone, you’ll have to find one that has special training to prescribe it. This can become complicated, but it is recognized as an important treatment in many places. You’ll meet with your doctor more often at the start of treatment, so make sure they’re someone you can build a good relationship with. This will help you get the best treatment possible.
Listen to Dr Scott MacDonald talk about how to choose a prescriber:
Here are some good places to start looking for a doctor
Substitution treatment clinics in the area
you can always checkout clinics near you to see if they are accepting new patients! Click on the icon above for list of clinics in BC
Substance use community services
Go to your family doctor or local pharmacist
Even if they can’t start you on substitution treatment, they might be able to give you names of doctors who can.
Go to a walk-in clinic
- Write a list of questions you want to ask your doctor
- If you think it’ll help, take someone with you to listen and take notes
- make sure you write down the date and time of your appointment. You don’t want to miss it!
The doctor will do a first assessment to make sure substitution is right for you. This will include:
- A physical examination including blood work and a urine test to test your health and if you are opioid dependent
- Questions about your drug use, physical and mental health, your home, family, work life, and if you’ve had problems with the law
- This is a good time to let your doctor know if you think or know you are pregnant. They will make sure you get the right support while on OST.
In this video, Dr Scott MacDonald talks about the different pathways to care:
2. Go to a Pharmacy
It’s really important the pharmacy you visit is close to you because you’ll likely need to go there on a daily basis. Make sure to ask if the pharmacy carries the medication that you need, because not all will!
Just like your doctor, it’s important to choose a pharmacy and pharmacist you can build a good relationship with.
Pharmacists are responsible for:
Making sure you get the right medication and dose
Supervising you when you take your medication if needed
Making sure you're in the right state to take your medications
Monitoring and helping you manage side effects or drug interactions
Being respectful and non-judgemental
3. Repeat!
You’ll need to visit your doctor on a regular basis until you’ve stabilized on the medication. Once stabilized, depending on the medication, you may have to go to the pharmacy every day or every few days. Click here to learn about your different medication options.
4. Start seeing a mental health worker or counsellor (Recommended)
Click here to see how a counsellor can help while in treatment