There are two main treatment options for prescription opioid problems:
- Methadone and buprenorphine. These medications improve treatment retention and reduce opioid use, HIV transmission and mortality. They suppress symptoms of opioid withdrawal, reduce cravings and block the euphoric effects of other opioids. Methadone and buprenorphine are given daily under the supervision of a pharmacist.
- Abstinence-based treatment. Patients sometimes initially request treatment that focuses on abstinence. While a trial of abstinence may be appropriate in some clients, it is important that they are aware that this method carries substantially higher relapse rates than methadone or buprenorphine treatment.
The Centre for Addiction and Mental Health has produced a series of videos for physicians and other health care providers about tapering opioids. Clinical Practice Tips: Effective Tapering Strategies for Prescription Opioids describe opioid use risks, clinical treatment considerations and opioid tapering protocols.
Evidence summary
Kahan, M. & Watts, K. (Eds.). (2011). Opioid misuse and addiction. Primary Care Addiction Toolkit. Toronto, ON: Centre for Addiction and Mental Health.