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Handbook Centre for Addiction
and Mental Health


How to use this book

When the methadone clients at the Opiate Clinic at the Centre for Addiction and Mental Health (CAMH) were asked what they wanted from a client handbook, they said they wanted a book that would give them all the information they needed in one place. They wanted something that would set the record straight on the length of treatment, side-effects, other drugs, counselling, pregnancy, travel, withdrawal and ending treatment. They wanted quotations from clients. They wanted it to be easy to read.

This book should answer many of the questions you may have about methadone treatment, and can help you to know what questions you should ask your doctor, pharmacist, counsellor and others. It’s put together so that you can either dip into it, or read it all at once, as you wish. There’s information here for those thinking about methadone treatment, for the new client and the long-term client, and for families and friends. You can use this information to help you to understand and make decisions about your treatment. You can use it to educate others. You can use it to help yourself get well.

Please note: In the process of posting this CAMH publication online, links to external sites were reviewed. In those cases where links have changed or are no longer in use, they have been deleted from the HTML (web page) version, but remain in the PDF versions. As a result, not all web pages will exactly match their PDF and print counterparts. The PDF versions will be updated if and when the print version is updated. We apologize for any inconvenience.

Table of Contents

Methadone myths and realities

  1. Methadone and other options
    • Is methadone maintenance treatment for you?
    • The benefits of MMT
    • The drawbacks of MMT
    • Other treatment options
    • Weighing your options
  2. Learning about methadone
    • What’s an opiate, what’s an opioid?
    • How do opioid drugs work?
    • Opioid dependence
    • How MMT works
    • The history of methadone and methadone maintenance
    • MMT in Ontario
  3. Going on methadone
    • How to get on methadone
    • Assessment
    • Consent and the treatment agreement
    • Dose
    • Cost
    • The urine sample
    • Community pharmacies
    • Confidentiality
    • A Patient’s Guide — Avoiding Overdose in the First Two Weeks of Methadone Treatment
  4. Living with methadone
    • Carry doses
    • When you can’t get to the clinic or pharmacy
    • Dealing with side-effects
    • Methadone and employment
    • HIV, hepatitis C and methadone
    • Resolving treatment problems
    • Changing methadone providers
    • Involuntary discharge
  5. Methadone and other drugs
    • Methadone and pain relief
    • Mixing methadone with other drugs
    • Safe injection
  6. Counselling and other services
    • Counselling services
    • The benefits of counselling
    • Methadone Anonymous
    • Learning to live without drugs
    • What’ll I do if I don’t do drugs?
  7. Women, family and methadone
    • Birth control
    • Pregnancy
    • Infant withdrawal
    • Breastfeeding
    • Child protection services
    • Menopause
  8. Looking ahead on methadone
    • How long will I be on methadone?
    • Tapering readiness
    • Methadone tapering
    • Changing your mind
    • After treatment ends


  • Important contact numbers
  • Web sites


The Centre for Addiction and Mental Health (CAMH) wishes to acknowledge the valuable and enthusiastic participation of methadone clients from across Ontario in the development of this handbook. Clients suggested what information we should include, they provided us with straight-up quotations about their experience and advice, and they reviewed and commented on the draft copy. Their involvement helped us to create a book that we believe will interest, inform and empower methadone clients throughout Ontario. Due to the restrictions of confidentiality we cannot list the names of the many clients who participated in the project, so instead we offer this expression of our earnest appreciation and gratitude for their contribution.

CAMH Switchboard 416-535-8501
CAMH General Information Toronto: 416-595-6111 Toll Free: 1-800-463-6273
Connex Ontario Help Lines
Queen St.
1001 Queen St. W
Toronto, ON
M6J 1H4
Russell St.
33 Russell St.
Toronto, ON
M5S 2S1
College St.
250 College St.
Toronto, ON
M5T 1R8
Ten offices across Ontario