All patients have both a right to treatment and a right to refuse treatment. We also believe that patients on a methadone plan who wish to go for abstinence treatment should have the right to do so. Moreover, with some users, being on methadone maintenance does not stop them from abusing a lot of other drugs. This complicates the situation and might lead to a dangerous health risk.
We follow the most recent guidelines published by the Canadian Medical Association that recommends initiation of opioid agonist treatment (with buprenorphine–naloxone whenever feasible), to reduce the risk of toxicity, morbidity and death, and to facilitate safer take-home dosing. This is a strong recommendation; high-quality evidence. It is recommended to initiate opioid agonist treatment with methadone only when treatment with buprenorphine–naloxone is not the preferred option.
Buprenorphine–naloxone has several safety advantages over methadone, including a reduced risk of fatal overdose, as well as a lower potential for respiratory depression.
As per the recommendations, we believe that for individuals who express a desire for treatment simplification could be considered for a transition to buprenorphine–naloxone, because of its superior safety profile (six times safer than methadone in terms of overdose risk and far less likely to cause overdose related harm). It also allows for more routine take-home dosing and less frequent medical appointments.
When transitioning from higher daily doses of methadone, there is an increased risk of substantial withdrawal symptoms and consequent relapse. Inpatient treatment and supervised withdrawal management programs may be required for safe conversion in such cases.
At Neworld Medical Detox, we follow such guidelines and recommendations. Our methadone clinic Toronto offer patients, on methadone, an alternative. We implement a specially customized methadone detox protocol for each and every case to safely detoxify clients off their use. Whatever the client’s methadone dose might be, our medical director has a methadone prescribing license and can safely do the taper to allow clients to shift to a more manageable dose. He then puts clients on alternative medication that has a better safety profile compared to methadone, can stop craving and prevent withdrawal symptoms, before withdrawing all the opioids out of the body system. We ensure that we use the appropriate prescription medications to allow our clients to recover from methadone use without serious side effects and minimal withdrawals. We are experts in this process and do our best to make this safe and effective. Clients walk out free of their methadone! Clients feel great as the methadone dosing burden is off their shoulders!