Any consideration of admitting a client into methadone maintenance treatment (MMT) only comes after the initial screening identified opioid dependence as a probable issue for the client (or some other presenting problem makes clear that opioid dependence is likely, e.g., withdrawal symptoms, double doctoring, infections related to intravenous drug use). Once a client has entered MMT, he or she will then be screened and/or assessed for the full range of concurrent substance use and mental health issues. Indeed, one of the aims of MMT is to address the acute issues related to opioid dependence so that other issues (e.g., problem drinking, cocaine use, nicotine dependence or concurrent depression) can be addressed.

Within MMT, assessment is carried out by the treating physician, the pharmacist and the counsellor, with each treatment team member focusing on issues related to their specialization. At the same time, the treatment team needs to maintain a biopsychosocial approach. Thus, for example, the pharmacist needs to be alert to signs of emerging mental health issues, while the counsellor needs to be aware of issues related to adequate dosing. The intensive assessments carried out by the physician and the counsellor are included in this module.

In this section:

Assessment: Physician

Assessment and treatment planning: Counsellor

Initial challenges for client and counsellors