FAQ & Addiction Resources

Road To Recovery FAQ

The staff at every Road to Recovery clinic are chosen very carefully with special attention paid to their ability to express professional compassion and deliver the highest quality of care. We believe addiction is a disease, and each patient should be treated just as you would if being treated for any other life-threatening disease. Our focus is on providing the best medication-assisted treatment and support services to address the issues specific to opiate addiction and associated problems (cocaine use disorder and mental illness).  We also offer treatment for smoking cessation and alcohol use disorder.  In select locations, our Road to Recovery patients can either walk-in or make appointments for general medical problems.  We employ virtual medicine by using Ontario Telemedicine Network (OTN), thereby improving efficiency, and reducing barriers to receiving timely care.  Road to Recovery Health Clinics employs a safer, more effective medication management system called PRESCRIBE-IT™ funded by Health Canada.  This allows for seamless integration with our existing electronic medical records (EMR) protecting and maintaining an influence-free dispensing & prescribing environment.

Road to Recovery abides by HIPAA Privacy Practices and cannot release any of your information without your written consent or a court order signed by a judge. At Road to Recovery, protecting and prioritizing your privacy and confidentiality is a matter of the utmost importance.

We do not automatically call CAS when you sign up on the program, if there is reasonable proof and thought of a child under the age of 16 being in harm, we have a duty to report as do other agencies, centres, and programs. 

Those who actively participate in counseling while in a medication-assisted treatment program are more likely to experience success in recovery.  The doctor and nurses will direct you to counselling. 

Addiction and Opioid FAQ

Addiction is a chronic, relapsing disease of the brain. This means simply that when using drugs or alcohol, those with the disease are unable to stop, even if they want to. Instead, the urge to continue taking their drug of choice overwhelms them, even if the drug is causing them harm.

Addiction is characterized by not only the inability to abstain from use for any significant length of time, but also an inability to control the amount taken when using. Additional symptoms can include the loss of behavioral control, cravings, physical withdrawal, inability to recognize the problems caused by use and inability to effectively manage almost all aspects of life.

Opiates are a group of drugs that are used for treating pain. They are derived from opium which naturally occurs in the poppy plant and are also created synthetically to replicate the effects of natural opiates. They go by a variety of names including opiates, opioids, and narcotics.

The term opiates are sometimes used for close relatives of opium such as codeine, morphine, and heroin, while the term opioids are used for the entire class of drugs including synthetic opiates such as OxyContin. While the terms are used interchangeably, the most common is opiate.

While many people consider OUD a result from lack of control it is a complex disease. Opioid use disorder causes physical and psychological changes that require medical treatment. The first time someone uses an opiate, the drug impacts certain receptors in the brain and the process of physical addiction begins. With ongoing opioid use, the brain begins to rely on opioids instead of the natural chemicals it produces. When addiction develops, the person requires opiates to avoid physical withdrawal symptoms. There are also psychological needs that are met using opioids making it a multi-faceted disease.

Below are some of the commonly used opiates, showing both their brand and generic names. They are listed in order of increasing strength.

  • Codeine®
  • Hycodan ® (generic: hydrocodone)
  • MS Contin Kadian ® (generic: morphine)
  • OxyContin®, Percocet ® (generic: oxycodone)
  • Dilaudid® (generic: hydromorphone)
  • Duragesic® (generic: fentanyl)
  • Heroin (illegal street drug)

Opioid agonist treatment often called (OAT), uses medications such as Suboxone® and methadone to treat opioid addiction reducing drug-related harms and support long-term recovery.

The Narcan Kit is supplied free to patients through their pharmacy by the Ontario government.  The kit contains a naloxone nasal spray or syringe that acts as an opioid antidote to reverse potentially fatal effects of an opioid overdose.  It is effective against all opioids.

No.  Naloxone is available in Canada without a prescription.

Program FAQ

Set up an intake appointment by contacting us by telephone or on-line as shown below.  You can also drop by a RTR clinic and present your OHIP card.  An initial appointment will be scheduled as soon as possible. 

  • Patients must be 18 years of age or older
  • Valid photo identification must be presented including a valid OHIP number
  • Evidence of opioid use disorder must be present as per DSM-V criteria
  • Agreement to follow program policies & procedures
  • Full consent to be agreed upon and signed by the patient prior to starting medication assisted treatment
  • A urine sample will be obtained periodically to assess for recent drug use

Virtual medicine has reduced barriers thereby drastically reducing the time it takes to receive medical treatment.  Please note that some things may affect this, such as weekends or holidays. 

In general, this occurs the same day you see your doctor.

No.  Road to Recovery Health Clinics employs a safer, more effective medication management system called PRESCRIBE-IT™.  This allows for seamless integration with existing electronic medical records (EMR).  This protects an influence-free dispensing and prescribing environment.

Clinic visits with the doctor are fully paid for if you have a valid OHIP card. 

In general, costs of medications may be covered under government plans such as Ontario Drug Benefits (ODB) or Non-Insured Health Benefits (NHIB), a private medical plan, or Trillium Drug Plan (TDP). Your pharmacist may try to assist you if you are having difficulty with payment.

In general, Road to Recovery physicians use either methadone or Suboxone® although there are possibilities to help patients, particularly in severe cases.

At Road to Recovery, we follow a patient-centered model of care. The doctor will present the possible choices for treatment including the benefits and possible risks, but the patient ultimately makes the final choice.

Buprenorphine, the active ingredient in Suboxone®, and methadone are both opioids and activate opioid receptors in the brain. Both are long-acting medications, and that makes them especially useful for the purposes of opioid addiction treatment. However, there are very key differences that distinguish these two medications from one another.
Buprenorphine is what is called a partial agonist, which means it does not activate receptors to the same level as methadone. The effects felt have a ceiling, meaning they will not reach an excessively high level, no matter how much the dose is increased so are more difficult to abuse (see attached graph). In addition to buprenorphine, Suboxone® contains naloxone, which acts as an antagonist blocking other opioids. Suboxone®, like other buprenorphine compounds, suppresses withdrawal symptoms and cravings while blocking other opioids, rendering it an effective treatment for opioid dependency.
Methadone is a full opioid agonist with no ceiling effect. This is like the way heroin impacts the brain as it is also a full agonist. Methadone can be more easily abused, and it is possible to overdose, however, once the right dosage is achieved, it too can also be successful in the treatment of opioid addiction.

The buprenorphine compounds that Road to Recovery patients take include Suboxone®, and Sublocade®. Suboxone® comes as small sublingual (under the tongue) tablets that are ineffective when swallowed. Sublocade® is a once-a-month intramuscular injection that is suitable for some patients already on the sublingual Suboxone®. All these medications contain a combination of buprenorphine and naloxone. Naloxone serves two purposes — blocking other opioids and deterring misuse. By causing withdrawal symptoms when taken incorrectly, naloxone reduces the risk of diversion. Road to Recovery medical providers help patients determine the best choice for their treatment.

Individuals with opioid use disorder are physically dependent on opioids and will experience painful withdrawal symptoms (e.g., fevers and chills, diarrhea, and other flu-like symptoms) without some form of opioid. Opioid agonist treatment, whether oral or injectable, is designed to prevent withdrawal symptoms and manage cravings in addition to replacing ongoing injection use of non-medical drugs that may be adulterated with safe, pharmaceutical-grade opioid agonists in safe and hygienic environments, thereby reducing the potential harms of IV drug use. This allows people to re-engage with the health care system and society rather than resort to drug-seeking and criminal behaviour to avoid withdrawal symptoms.

Once ingested you will feel the benefits for ~ 24 to 36 hours. It is important to take your dose once a day at the same time everyday. Some people metabolize Methadone at a faster or slower rate than others. Your doctor will help you get the proper dose for your needs.

Opiate withdrawal can be extremely uncomfortable. Treatment with methadone or a buprenorphine compound is intended to eliminate the discomfort caused by withdrawal, and therefore eliminate the cravings that so often lead to relapse.
While you may not feel 100% back to normal during your first days of treatment with Suboxone®, you will continue to improve as your dose is stabilized which typically occurs in 7 days or less. Methadone on the other hand, typically takes about 2 weeks. Your withdrawals will continue to decrease until you are no longer experiencing them at all.
It is important to remember that opiate withdrawal is not life threatening if you are withdrawing only from opiates and not a combination of drugs. Be sure to inform your doctor of any other drugs or medications you may be taking.

Taking mood altering substances while on methadone orSuboxone® can be potentially dangerous. There have been reported deaths, by the combination of methadone with alcohol, opioids, cocaine, barbiturates, benzodiazepines and/or tranquilizers.

Yes, you can, but we will ask for your written consent to contact the prescribing physician. We will use a standardized questionnaire that will shed light upon the rationale for its use. In addition, we will be able to inform your prescribing physician that you are now starting OATC. This policy is for your own safety first, and first and foremost, and will enable you to potentially get take-home/carry doses in the future.

You might get constipated. If this happens eat high fiber food and drink lots of water. In difficult cases your doctor can prescribe you stool softeners.

Methadone (and to a lesser extent Suboxone®) can result in hypogonadism. A blood test to check total testosterone and free testosterone levels will verify this. This condition is reversible but requires a prescription for testosterone gel or intramuscular injection.

For the first two months you will have to go everyday (see below). After that you can get some doses to take home with you if you are “clean.” Even after a year you will still have to go once a week. There are exceptions that can be made for work related travel and vacations. 

In general, physicians follow the 2011 Methadone Standards & Guidelines, but this may change with the development of new guidelines in 2021.  Based on the existing methadone standards you must have been on the program for 2 months and are able to handle carries safely, your physician will prescribe take-home doses at a rate of one dose per week every four weeks, to a maximum of six take-home doses per week.  Each additional take-home dose will only be prescribed after you have had at least four weeks without problematic substance abuse.  Suboxone® is theoretically less dangerous than methadone and carries can be granted in the first month or earlier (particularly during the Covid-19 pandemic).

No.  You earned those carries and are entitled to keep them.

The frequency of UDS is at the discretion of each doctor.  In most cases you leave samples once or twice a week until you reach full carries at which time a urine sample is required weekly

No. You will not be asked to leave the program as Road to Recovery believes in the harm reduction approach to the treatment of OUD.

Some patients interested in OAT hesitate because they worry that buprenorphine (Suboxone®) will appear on drug screenings. As a Road to Recovery patient, you will have protection from job discrimination based on your treatment. While some professional drug screenings do check for buprenorphine, standard tests do not, and your Recovery-to-Recovery team can help you inform the testing lab that you take it. Under federal law, an employer cannot deny you a job or fire you based on your status as a patient receiving OAT.

If you are not content with your initial decision you can switch between methadone and Suboxone® quite easily.  Using the Suboxone® micro-dosing protocol you may slowly reduce the prescribed methadone dose while simultaneously increasing Suboxone® in micro-dose amounts over the span of 7-10 days.  Similarly, you may transfer to methadone from Suboxone® under physician guidance.

Methadone has been used for decades in females who are pregnant.  Methadone prevents opioid withdrawal, which can be dangerous for your baby. According to research, buprenorphine alone may help pregnant patients reduce their risk of neonatal abstinence syndrome, a condition that happens due to opioid exposure in the womb.  The decision to continue use of Suboxone® (buprenorphine and naloxone) during pregnancy should only occur following a detailed discussion with the patient’s healthcare provider.

There is no specified duration of time for a medication-assisted treatment program. Each person’s journey in treatment is unique, and the length of treatment is impacted by a few factors including how long and how much they used and whether they participate in counseling and other recovery support services. Experts indicate that success in opiate agonist treatment (OAT) is much more likely for those who participate for a minimum of one year.

Patients at Road to Recovery receive appointment-based, outpatient care. As a result, you can continue to fulfill your daily obligations while going through treatment.

There are hundreds of pharmacies that dispense methadone or Suboxone® across Ontario.  In the former case we would forward your prescription to the pharmacy of your choice.  In the latter situation, we do not want you to withdrawal and so the doctor will forward a temporary prescription to your usual pharmacy. 

General FAQ

When you begin a recovery program, the priority is to address the physical withdrawals and cravings you are experiencing. As the medication prescribed begins to work, you can look to begin improving your overall health and well-being. This is the time when you can begin to focus on nutrition, exercise. Health foods and plenty of water are the keys to the rebuilding process the body is going through in recovery. Aerobic exercise is one way to encourage the natural production and release of hormones which help improve mood and concentration, while sleep offers the body the break it needs to put these new habits to work to repair the damage caused by drug and alcohol use. Smoking cessation can significantly improve your health and well-being by reducing the risk of cancers, stroke, heart attack and multiple other insults that cigarette smoke exerts on your bodily organs.

A support system holds you accountable, encourages you and helps to eliminate the feelings of loneliness through acceptance and hope. It helps to know that others have experiences like yours and understand your struggle with addiction. This type of community support can be found through:

  • group counseling sessions at a medication-assisted treatment program
  • at a 12-step meeting (Narcotics or Alcohol Anonymous)
  • in other recovery groups such as sober living houses

Many individuals who have been struggling with addiction feel very alone. The relationships with family and friends have likely been strained, and some may seem irreparably broken, but it is important to build a strong support group as you work your treatment program. As you begin to heal, your relationships with family and friends can also begin to heal.

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