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What is Methadone? How do I Access Methadone Treatment / Detox Options?
Methadone is also an opioid medication, but it is generally used for opiate/opioid detoxification and harm reduction maintenance programs. Unlike other opiates, Methadone is slow-releasing. It prevents opioid withdrawal symptoms and allows individuals to stabilize and improve their lives (i.e. don’t have to worry about when and where they’ll get their next “fix”). The idea behind methadone is to start on a higher dose after switching from other opioids and reducing dosage amounts as tolerable until a person no longer needs it to function. Other resources are needed to facilitate full abstinence. A prescription is needed for Methadone and users must ingest the liquid at a pharmacy each time. On rare occasions, some users are permitted to take a small supply of Methadone home.
Starting dosages for Methadone/Methadose/Suboxone are 20-30mg depending on the province and the prescribing physician. This dosage amount is intended to protect patients from overdosing. However, many users report that the starting dosage is not enough, causing a large percentage of users to continue using other opiates/opioids until their dosage is high enough to keep the cravings at bay.
Note: Methadone is BC has been replaced with a new formula called Methadose (10x stronger than methadone). Users have reported heightened withdrawal symptoms with Methadose and, as a result, decreasing quality of life.
What is Suboxone? How do I Access Suboxone Treatment / Detox Options?
Similar to Methadone, Suboxone (or Buprenorphine) is an opioid medication. Unlike Methadone, a full opiate agonist, Suboxone is only a partial opiate agonist, meaning its effects are limited even in higher doses. Because Suboxone is harder to misuse, users are permitted to take their prescription home. Suboxone is generally more expensive than Methadone.
Depending on your location, Suboxone can be prescribed by your GP or a clinic specializing in Suboxone, Methadone, and opiate-replacement therapies (e.g prescription heroin).
Some treatment centres in Canada also provide Suboxone Treatment as part of their programming and detox services.
For information on our specialized detox services including Suboxone Treatment, see our Specialized Detox page.
Will I be on Suboxone or Methadone Forever?
Just like other opiates, ceasing Suboxone or Methadone use will likely involve some degree of withdrawals. Suboxone generally has fewer withdrawal effects than Methadone. Not many facilities in British Columbia or Canada as a whole offer Suboxone and/or Methadone detox. Some facilities permit these maintenance medications if there are under a certain dose and/or are willing to taper and stop use completely.
Clients in our drug rehab programs (based in Powell River, BC, not far from Vancouver and Victoria) who are on Suboxone Treatment are entitled to a complementary taper off Suboxone after a 1-year minimum of use. See our Suboxone Treatment page for more details.
Where can I get Detox and/or Treatment for Suboxone or Methadone?
It depends on what province you live in in Canada and how much money you plan to spend. If you can pay for private treatment or what is commonly called “private Suboxone or Methodone detox,” most facilities will have a doctor who can taper you off of Suboxone and/or Methadone. Depending on how high your dosage is, you will be in detox/withdrawal from 10-90 days. The higher the dose the longer the stay. Prices for private treatment / private drug detox in Vancouver and other major Canadian cities range from $5,000-$25,000. If you cannot afford private Suboxone or Methadone treatment, then public drug rehabs are your best option.
Most provincial detox units (e.g., British Columbia, Alberta, etc.) will have their own admission guidelines that prevent most Methadone and/or Suboxone users from being able to withdraw at a residential detox unit. The majority of the detox units in Canada require you to be at 0 mg or on your last dose of Methadone or Suboxone prior to admission. This means that they will see you through the final withdrawal period from your substitution therapy. There are a handful of detox units in Canada that will do a complete detox (e.g. not taper) from 25-30 mg or less.
Being on Methadone/Suboxone/Methadose is difficult if a patient wants to seek residential treatment. The majority of all facilities – public, charitable, and private – do not accept clients who are stabilized. There has been a slow increase, but there is still a huge gap between treatment programs that provide and/or accept Suboxone Treatment. It’s a catch 22 for a large number of individuals stabilized on substitution drugs for their opioid/opiate addiction.
How Fast do I Taper off Suboxone or Methadone in Treatment?
Guidelines for tapering are established by the College of Surgeons and Physicians in your province. Common guidelines are a 5-7 mg or 10% reduction per week for Methadone. Currently, there is not a common tapering protocol for Suboxone, but it should be roughly the same. Most clients will have doctors who will want to set them up for success, so the taper will be roughly 2.5 mg every 2 weeks. This gives the body more time to adjust to a lower dosage, making the withdrawal process more bearable. However, if you started at 50 mg, this would mean you will be tapering for 40 weeks until you are at 0 mg.
SCHC’s detox unit offers drug detox services for individuals wishing to go from Opiates (e.g. Fentanyl, heroin, etc.) to Suboxone or Methadone/Methadose to Suboxone as well as Suboxone Taper for people who’ve been on Suboxone Treatment for 1 year or more. See our Specialized Detox page and Suboxone Treatment page for more details.