Knowledge Centre

Opioid use disorder (OUD) is a medical condition. Some people develop opioid use disorder due to increased or long term use of opioids. It is important to note that OUD can occur without the misuse of the medication. Even when people take Opioids appropriately and according to their prescription, dependency can occur.

Opioids are central nervous system depressants. They can be taken to reduce pain or they can also cause relaxation or provide a high. Opioids can be prescribed or obtained illicitly. Opioids can include Fentanyl, Oxycodone, OxyNEO, Hyrdocodone, morphine, heroin, methadone, and Percocet.

Individuals with OUD experience cravings and withdrawal symptoms, and have difficulty stopping their use even when they want to. OUD is not related to a person’s character, will power, or morals, and has nothing to do with the kind of person you are.

When addictive substances like opioids are taken in excess, they activate the brain’s reward system. An increased and long-lasting release of dopamine in our brains causes us to remember the pleasure of the activity and directs us to use again. Our brains tell us that using opioids is even more important than survival activities, which makes it very difficult to “just stop.”

People who have Opioid Use Disorder usually have the following four traits:

• They cannot control their opioid use.
• They continue to use opioids even though it harms them.
• They spend a lot of time obtaining opioids, using opioids, and recovering from use.
• They have powerful cravings to use opioids.

If you take high doses of opioids every day for several weeks or more, your nervous system changes to resist the drowsiness that they cause. This change is called tolerance. People who use opioids daily are often able to function normally even after taking amounts that would be fatal to someone who does not take opioids.

When reducing or stopping drug use, people with a dependency often experience pain and other uncomfortable symptoms. This withdrawal is usually at its worst two or three days after last use, although the symptoms can linger for weeks or months.

The physical symptoms of withdrawal are like a very bad case of the flu; people experience muscle aches, nausea and vomiting, cramps, chills, sweating, yawning, and goosebumps. In addition, people often experience psychological symptoms such as severe insomnia, anxiety, fatigue, and powerful cravings. These psychological symptoms are usually much more uncomfortable than the physical symptoms.

You and your health care provider should discuss which treatment or combination of treatments would be helpful in your recovery.

Medication:
Individuals who experience withdrawal symptoms when they stop using opioids may be offered medication, also known as opioid agonist therapy. Suboxone (buprenorphine/naloxone) and methadone are both slow-acting and long-lasting opioid medications that, in the right dose, prevent withdrawal and cravings for a full 24 hours without causing intoxication. By preventing these symptoms, these medications allow people to “feel normal” and to focus on other important things in life.

Counselling and other supports:
Supports can be an important part of treatment for many people. Counselling can include education about addiction, harm reduction, healthy lifestyle choices, coping skills, cognitive behavioural therapy, and peer support. Links to support groups, E-mental health programs, employment services, housing, income, and family supports can also be helpful and are available to individuals and families affected by opioid use disorder.

Opioid Treatment Centres

These Centres are part of the new provincial Hub and Spoke model that is being implemented to provide rapid access to opioid dependence treatment throughout the province.

Referral is not needed. Please call a Centre directly or discuss your opioid concern with a healthcare provider:

St. John’s
Building 532, 80 Charter Avenue (Pleasantville)
Please call us at (709) 752-4478

Gander
50 Memorial Drive East
Please call us at (709) 256-1356

Corner Brook
35 Boones Road
Please call us at (709) 634-4506

Stephenville
127 Montana Drive
Please call us at (709) 643-8740

Happy Valley-Goose Bay
Please call us at (709) 897-2344

Family Physicians and Nurse Practitioners
Many physicians and nurse practitioners can prescribe medication-assisted treatment (Suboxone or methadone), and they are located throughout the province. Counsellors are also available. Feel free to discuss any opioid-related concerns with your healthcare provider.

• If you do not have a physician or healthcare provider, please call 811 and a HealthLine nurse will give you with contact information for your area.

Take Home Naloxone Kits

• Call 911 right away if you think that someone is having an overdose.

Naloxone is a temporary medication that can save a life in the event of a fentanyl or other opioid overdose. Naloxone Kits and instruction are free.

Get a Kit
If you are at risk of an opioid overdose or you might witness an overdose, please find a Naloxone Kit near you:

• Call 811 and a Healthline nurse will provide you with a contact number and location.
• Click on the MAP of Distribution Sites.
• Click here for a list: http://www.health.gov.nl.ca/health/naloxonekits/