Frequently Asked Questions.

Some frequently asked questions have to do with rumors people have heard about addiction treatment. Others are just common questions that people ask all the time. Scroll down to find the answers to the most common questions.

If I change clinics to ACT will I have to re-start at the lowest dose and I will lose all my carries?

If your patient chart is transferred from your current clinic to ACT, you have not missed any doses, you provide a clean urine sample, and receipt for your last dose, your dose and carries will remain the same.

I heard there is some kind of registry and I have to wait for days if I want to start treatment and I have to get cessation papers before I can change clinics. Is this true?

There was a registry with the CPSO that was discontinued on July 6th 2015. According to the CPSO, patients no longer need initiation, transfer, or cessation forms. You can start treatment or transfer between clinics without any need for registration.

I heard ACT kicks people out of the program if they are not off drugs in two years. Is this how the clinic works?

You can stay in treatment for as long as you like. We have patients who have been in the program since the first ACT clinic opened. Two years is about the average amount of time it takes to get off drugs in our program, but it varies. Time is needed to make lifestyle changes.

We do have patients who taper off their medication and leave the program after various periods of time. This is not because they are forced to do it. This is because they feel they no longer need medication.

Will (Opioid Substitution Therapy) OST make me sick?

OST will not bring on any type of illness. If your dose is too low you may start to feel withdrawal symptoms.

This is not the medication making you “sick” but your body responding to a lack of opioids in your system. If this happens inform your doctor and they may adjust your dose upwards.

For certain types of OST medication you will have to go into withdrawal in order to start taking the medication. If properly prescribed and taken as directed this medication will not make you “sick.”

Side effects may include but are not limited to the following: Sweating, constipation, dry mouth, weight gain, irregular heartbeat, depressed respiration, and drowsiness. For a complete list of all possible side effects contact a doctor or pharmacist.

Will OST damage my teeth?

One of the side effects of OST is dry mouth. This can cause a buildup of plaque on your teeth, which can cause gum disease or tooth decay. Counteract this by brushing your teeth, flossing, using mouthwash, and drinking water.

Is it true that OST makes your bones ache?

OST will not interfere with the normal functioning of your internal organs and will not bring on any type of illness. If your dose is too low you may start to feel withdrawal symptoms.

Will OST make me gain weight?

Many addictive drugs suppress the appetite. Once you are on OST your health and appetite will improve and weight gain is normal. OST can cause water retention and can slow your metabolism. Eating healthy foods will ensure a healthy body weight.

How are the side effects of OST different than what I’m on now?

Since all opioid drugs are related they all share the same side effects. Your side effects may be similar to what you are experiencing now but somewhat milder because of your constant level dose.

Will I get constipated?

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.

Will I get “the sweats?”

Some people do experience excessive sweating. Lowering the dose may control this. Sometimes lowering the dose does not work and you just have to live with it.

If I’m on OST can I still take other drugs?

No. If you are still interested in taking other drugs you’re not ready for OST. OST medications are very dangerous if you take other drugs with them. The vast majority of deaths related to OST occur in the first two weeks of treatment.

During this time your body is not fully accustomed to the medication. If other drugs are used during this time you put yourself in danger of an overdose and death.

Is OST legal?

The medication that is prescribed by our physicians and provided directly to our patients by a pharmacy is 100% legal.

It is manufactured to strict guidelines.

As long as you use your prescribed medication as directed by your physician it is 100% legal for you to use and possess.

How much does OST cost?

It costs on average about $5.00 – $15.00 per dose depending on the pharmacy, amount and type of medication prescribed.

If you have an Ontario Drug Benefit Card or a prescription drug plan through your work the cost may be covered.

You may also qualify for financial assistance through the Trillium Drug Plan.

How often do I have to take OST medication?

Once ingested you will feel the benefits for 24 to 36 hours. It is important to take your dose as directed by your doctor.

Some people metabolize opioids at a faster or slower rate than others. Your doctor will help you get the proper dose for your needs.

In the rare case of rapid metabolism some people will be prescribed a “split dose” to be taken at 12 hour intervals instead of 24 hour intervals.

I’ve got a case pending that I might not beat. Can I get OST in jail?

Let your doctor know about your legal problems and they may be able to act as an advocate for you and help you continue treatment in jail. This is situational and will depend upon the jail and the pharmacy.

Currently you can continue treatment in jail but you can’t start it in jail. It’s best to start before you go inside – otherwise you’ll be withdrawing in jail.

Why do you put the “drink” liquid OST medication in orange juice?

The “drink” liquid opioid antagonist is an odorless colorless liquid and it tastes bitter. The orange juice masks the bitter taste. The citric acid in the orange juice prevents people from injecting it.

Why would anyone inject it?

Some people don’t understand that you can just drink it. Some people are also psychologically addicted to injecting their drugs. Injecting, snorting or smoking OST medication is dangerous and should never be done.

I’ve heard of people drinking two cups of juice at the pharmacy. Are they taking two doses?

The first cup contains the OST medication. The second cup is just plain orange juice. Drinking the second cup ensures that the first cup has been swallowed. Your pharmacist may require you to prove you swallowed by opening your mouth after drinking your dose.

If I miss a dose will I get sick?

Just like missing a dose of your regular drug of choice you’ll start to feel the effects of withdrawal.

Do I have to quit OST eventually?

No. Some people have been on it for over twenty years. If you don’t want to stop you don’t have to.

Dose “tapering” is a wise thing to do because you don’t want to be taking more than you need to.

Once tapered you can maintain at a low dose for a very long time.

Do I have to go to the pharmacy every day to get my dose?

For the first two months you will have to go everyday. After that you can get some doses to take home with you if you are “clean.”

This means providing clean urine samples. Even after a year you’ll still have to go once a week. There are exceptions that can be made for work related travel and vacations.

Someone told me not to drink grapefruit juice or take St. Johns Wort. What’s the deal?

These two common substances have an adverse effect on the opioids in your system. Do not take them as long as you are on OST.

Can I overdose on OST medications?

Yes. OST medications stay in your system for a very long time. If doses are taken too close together the doses start to stack up in your system and can build into an overdose and possibly, death. That is why it is very important to take your dose at the same time everyday.

What happens if I take other opioids in combination with my OST medication?

The liquid opioid agonist blocks the euphoric effects of all opioid drugs. It does not block the effect of the drugs on your central nervous system. The doses of the other drugs added to the OST medication could cause an overdose and possibly death.

The sublingual film OST medication also blocks the euphoric effects. Again the doses of the other drugs added to the OST medication could cause an overdose and possibly death. In other words you won’t get high and you could die as a result.

Does OST medication produce a euphoric effect like other opioids?

No. When you first start treatment you may feel lightheaded or sleepy for a few days.

What happens if I take other non-opioid drugs while I’m on liquid OST medication?

Alcohol and benzodiazepine drugs like tranquilizers and sleeping pills are all Central Nervous System Depressants. They slow down breathing and can cause cardiac arrest (stop your heart) or respiratory failure.

Cocaine and Crack also pose dangers that could lead to cardiac arrest and death. Marijuana has depressant effects and affects the respiratory system and may interfere with other prescriptions you are taking.

Most Marijuana on the streets is “laced” with other substances like cocaine. This can cause Cocaine to show up in your urine tests even though you only smoked Marijuana.

If I show up at the pharmacy after I’ve been drinking alcohol will I still get my dose?

You won’t be given your dose unless the pharmacist is convinced that it is safe for you to do so. Alcohol can also speed up the metabolism of medication in your body leading to early onset of withdrawal symptoms.

I want to try OST Medication before I join the program. Can I just buy some on the street?

No. Starting doses can be strong enough to cause death in an average person. This is serious medication and if taken without the proper supervision and education it can be fatal.

Also certain OST medication if taken improperly can cause precipitated withdrawal and will make you “sick.”

How do I know if OST will be dangerous for me?

People at risk may include:

  • Anyone who has been taking benzodiazepines or other sedative drugs.
  • People with chronic drinking problems.
  • People over the age of 60.
  • Anyone with respiratory problems like pneumonia.
  • Anyone currently taking opioid antagonists.

I’ve already gone through withdrawal. Will you still give me OST?

The doctor will assess your medical and drug use history and determine if treatment is right for you. If you are accepted your initial dose will be lower than for people currently using opioids. Dose increases will also be lower.

I heard some people get very high doses. Is this true?

Some people have an innate tolerance to opioids. Some people metabolize opioids at a higher rate than normal.

These people may require a higher dose – or a split dose where two smaller doses are taken daily instead of one normal dose.

These conditions are rare and you’ll probably fall into the normal category.

How long will I be on OST?

You’ll be on OST for as long as you want. Some people stay on for as long as twenty years. You never have to stop taking it if you don’t want to. If you want to stop taking it or reduce the amount you take your doctor can “taper” your dose.

Is there anything else to know about OST medications?

Yes. There are two main types prescribed for OST. To find out more about them click here.

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