A physician from CRAN answers your questions

4. I’m a family physician and I have a patient who has been on methadone treatment for five years. He has a generalized anxiety disorder that he refuses to take medication for. At first, my patient managed to reduce his heroin use significantly, but he gr

Some users have difficulty stopping using despite the prescribed methadone treatment. When this happens, it’s important to work in collaboration with other professionals to optimize the addiction treatment. This user would benefit from psychosocial support and acupuncture to learn how to manage his anxiety. To obtain these services, he can contact CRAN, his local community services centre (centre local de services communautaires – CLSC) for psychological support or a private acupuncture clinic.

3. I’m a family physician. A user has asked me to increase his dose of methadone: he complains that it doesn’t last 24 hours. However, during the consultation, he didn’t seem to be in withdrawal. When I went to see him in the waiting room, he was asleep i

Check what time he took the medication at and determine whether it is one of the following situations:

2. When can the first take-home dose of methadone or buprenorphine be prescribed?

According to the Collège des médecins du Québec guidelines, the first take-home dose can be prescribed three months after starting methadone treatment or two months after starting buprenorphine treatment (this medication is safer than methadone).

This length of time is given by way of indication only. It is a window that allows the physician or health care team to build a relationship of trust with the user and collect the necessary information.
 

1. I’m a family physician. For the past two years, I’ve been following a user who takes opioids once or twice a week on average. He has to take his dose of methadone in front of a pharmacist four days a week. This user would like to have more take-home do

The main criterion in deciding to allow take-home doses of methadone or buprenorphine is the user’s level of organization. A person who uses is not necessarily disorganized. It’s important to have an overall picture of his situation, which includes: