Opioid Agonist Therapy (OAT)

Addiction to opioids like Heroin, Oxycodone and Percocet can feel like a losing battle. An effective treatment plan to consider is Opioid Agonist Therapy (OAT). OAT is a comprehensive therapy that includes taking prescribed medication that reverses the effects of the opioids in your system and will prevent withdrawal symptoms and cravings. OAT works best when other supportive services like counselling are included in the treatment plan.

Methadone and buprenorphine are long-acting opioid drugs that are used to replace the shorter-acting opioids the person is addicted to. Long-acting means that the drug acts more slowly in the body, for a longer period of time. By acting slowly, it prevents withdrawal for 24 to 36 hours without causing a person to get high. OAT also helps to reduce or eliminate cravings for opioid drugs.

When you first start taking OAT medication, you might feel lightheaded or even sleepy, but your body will adjust once you are on a stable dose. For most people, this adjustment period takes about two months. The primary purpose of OAT is to help you get back to living a normal life without feeling “over-medicated”.

Most types of OAT medication is taken orally to avoid any kind of association with inhaling or injecting drugs. The first few months of your treatment will be closely monitored and adjusted to achieve the optimum dose to prevent cravings and withdrawal.

You will have to take the prescribed OAT medication at your local pharmacy – this is called “daily witnessed ingestion”. Once your doses have stabilized, and a medical expert has assessed your situation, you can start taking medication home. These doses are called “carries”. Your use will be tracked by a healthcare professional who will also check-in regularly to make sure your treatment plan stays on track and that no doses are skipped. Missed doses can increase the risk of relapse.

Some people do experience side effects during the early stages of treatment, or when they are on a higher dose. Side effects tend to be stronger with Methadone. Side-effects can include drowsiness, constipation, weight gain, excessive sweating, dry mouth, and changes in sex drive.

OAT medication can be extremely dangerous when mixed with alcohol, herbal remedies or any form of Benzodiazepines like Ativan, Xanax, Restoril or Valium. Other drugs can cause your dose to wear off quickly, meaning you could experience withdrawal and cravings.

Always consult with your pharmacist or doctor first about the types of medication you can take with OAT medication.

There are many factors to keep in mind:

• Did your addiction start with physical or emotional injury? Or trauma? Using opioids for a long time can cause changes in the brain that make it difficult to live without them. Stopping OAT before you are ready, can cause relapse and/or overdose.
• People who start their treatment usually continue for at least a year or two, while some continue for many years. Your doctor and other healthcare professionals will assist and will consult with you on the duration of your treatment.

Differences between buprenorphine and methadone include the following:

• Buprenorphine/naloxone is a pill that is absorbed under the tongue (sublingual), or it comes as a film, whereas methadone is taken as a drink.
• Suboxone® is now available as an injectable monthly form called Sublocade®.
• Buprenorphine has a lower risk of overdose than methadone.
• Methadone is most commonly available through specialized treatment clinics.
• From initiation, it can take weeks to reach a fully effective dose with methadone but only a few days with buprenorphine.
• Side-effects can be less pronounced with buprenorphine.

If your pain is from withdrawal, OAT may help. OAT can also relieve other types of pain for a few hours. If pain continues after your dose is stabilized, talk to your doctor about other options. Are there safety risks? Trained health care professionals follow strict guidelines to deliver methadone and buprenorphine as OAT. These drugs are safe based on thorough research.

Trained health care professionals follow strict guidelines to deliver methadone and buprenorphine as OAT. Thorough research has been done on these drugs to establish their safe use. People take OAT for years without any ill effects. However, methadone and buprenorphine are powerful drugs. They can be extremely dangerous if taken by someone for whom they are not prescribed. Never sell or give away any of your dose. Children are particularly at risk. Even a small amount can be fatal for a child. Always store your carries in a locked box. All opioid drugs have a risk of overdose. The risk is higher with methadone than with buprenorphine. The risk is especially high when you start treatment, and if you stop taking opioids for a while and then start again. Mixing opioids with other drugs that depress the central nervous system can be extremely dangerous. Avoid other opioids, alcohol and benzodiazepines (e.g., Ativan, Xanax, Restoril, Valium, clonazepam). Taking these is especially risky when you first start OAT. Using other drugs while taking OAT can also cause your dose of OAT to wear off more quickly, meaning you could experience withdrawal.