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Making the Choice, Making It Work


Second edition—formerly published as Methadone Maintenance Treatment: Client Handbook

How to use this book

Opioid agonist therapy FAQs

Opioid agonist therapy and other options
Learning about opioid agonist therapy
Starting opioid agonist therapy
Living with opioid agonist therapy
Opioid agonist therapy and other drugs
Counselling and other supports
Birth control, pregnancy, family and opioid agonist therapy
Looking ahead on opioid agonist therapy

Important contacts



The Centre for Addiction and Mental Health (CAMH) wishes to acknowledge the enthusiastic and valuable participation of the many clients, family members and health and social service professionals who contributed to the redevelopment of this handbook. Our gratitude also extends to all who contributed to the conception and development of  Methadone Maintenance Treatment: Client Handbook, first published by CAMH in 2001, which provided a foundation for this new edition. 

Creating this handbook has been a collaborative effort with professionals, clients and family members reviewing drafts and providing feedback, which was then carefully overlaid and woven into drafts based on the original handbook. The aim of this process was to create a book that carried forward the success of the original handbook, but that reflects the current realities of opioid addiction and treatment. We hope that this new edition will interest and inform people with addiction to opioids, and empower them to direct their own treatment and recovery. We hope that it will also help families, friends and others with an interest in opioid addiction and treatment to better understand the issue, and the people who struggle with it.

A special heartfelt thanks goes out to the people with experience of opioid agonist therapy (OAT) who provided us with the thoughtful quotations that illustrate the book. Your voices tell us that there is no one kind of person who becomes addicted to opioids, or no one kind of experience with the struggle to live with it. We also deeply appreciate the clients and family members who carefully reviewed a draft of the handbook, and provided their feedback.

Client quotes were provided by Andy, Angie, Ann, Ben, Brett, Chantale, Courtney, Dan, David, Eric, Gemma, Glen, J, Jessica, Jim, Jon, Josée, Joyce, Paul, Randall, Ruth, Sean, Shaun and Zar.

Clients and family members who reviewed the draft are Gemma Bennett, Malcolm Birbeck, Dante T. Colaianni Jr., Tammy Hyde, Jon, Betty-Lou Kristy, Sean LeBlanc, Patrick Loewen, Randy Post, Bill and Sheila Robinson, Charlene Winger, Sean Winger and others who chose to withhold their names.

This project would not have been possible without the contribution of the nurses, doctors, pharmacists, counsellors and other professionals whose work supports people with opioid addiction. These reviewers volunteered their time, thoughts and expertise from CAMH, across Ontario and across Canada.

Professionals from organizations outside CAMH also reviewed the draft: Kim Hennessy, Uptown Methadone Clinic, Saint John; Joni Ingram, Western Health, Cornerbrook; David Marsh, Northern Ontario School of Medicine and Canadian Addiction Treatment Centres; Tim Ominika, Nadmadwin Mental Health Clinic, Wikwemikong; Kendrah Rose, Sunshine Coast Mental Health & Addiction Services, Vancouver Coastal Health; Rhonda Thompson, Positive Living, Niagara; Andrew Tolmie, School of Pharmacy, University of Waterloo.

And the professionals who work at CAMH who gave their comments were Roshina Babaei-Rad, Carol Batstone, Alison Benedict, Jonathan Bertram, Narges Beyraghi, Susan Eckerle Curwood, Stephanie Gloyn, Katia Gouveia, Ahmed Hassan, Galit Kadan, Lisa Lefebvre, Heather Lillico, Tamar Meyer, Niall Tamayo, Kari Van Camp and Maria Zhang.

Thank you to CAMH’s Provincial System Support Program (PSSP) central and regional team members for their support in organizing and conducting the client interviews, and in reviewing and commenting on the drafts. PSSP would especially like to acknowledge those who helped to organize and facilitate the focus groups of people with lived experience of opioid addiction. Thanks to Sean LeBlanc for facilitating the group in Ottawa and to Rob Boyd and Hana Dykstra of the Sandy Hill Community Health Centre for supporting the group; thanks also to Betty-Lou Kristy for facilitating the group in Oakville and Katie Kidd of the Opioid Outreach & Treatment Services of
Missisauga/Halton for supporting the group. The feedback collected through these groups helped to shape the final draft, and to ensure that the guide is helpful to the people who can benefit from the information it provides.

Client interviews were conducted by Lia De Pauw, Erika Espinoza, Alexandra Lamoureux, Heather Lillico, Janet McAllister, Barb Steep and Cheryl Vrkljan; thanks also to The Hamilton Clinic; Ontario Addiction Treatment Centres; Street Health Centre, part of Kingston Community Health Centre; and Shannon Greene and the CAMH Addiction Medicine Service.

Other professionals who helped to answer questions and to provide accurate content are Ken English and Fiona Sillars, Ontario Ministry of Health and Long-Term Care; Steve Grootenboer, Ontario Ministry of Transportation; Tracey Marshall, College of Physicians and Surgeons of Ontario; Linda Ogilvie, Ontario Ministry of Community Safety and Correctional Services; and James L. Sorensen, University of California, San Francisco (for permission to adapt and reprint the Tapering Readiness Inventory).

The CAMH Education team for this project was Michelle Maynes, writing and development; Mara Korkola, design; and Jacquelyn Waller-Vintar, editorial.​​​​​​​​​​​​​​

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