Opioid Treatment Assessment & Consents

Assessment

Before you can begin taking methadone or suboxone, it must be decided which treatment is the right one for you. To make this decision, the doctor, and perhaps a nurse, counsellor, or intake worker, will need to take some time with you to get to know you. This process, called “assessment,” gives your treatment providers the information they need to get you started.

You can expect the assessment to look at you as a “whole person.” Assessment includes a physical examination by a doctor and a urine test to establish that you are opioid dependent. Assessment may also include a chest X-ray to check for tuberculosis, and, with your permission, a blood test for HIV and hepatitis. You can expect to be asked questions about your drug use, your physical and mental health, your home and family, your work, and you may be asked if you’ve had problems with the law.

Keep in mind that no one is judging you. Your doctor, and any others who interview you, are only interested in giving you the treatment that you have come looking for. Try to answer all questions as honestly as you can.

Assessment is also your opportunity to get to know the people who are providing the treatment. Don’t be afraid to ask questions. Find out what you’re being tested for.  Ask what other services are available along with the opioid substitution treatment. Gather the information you need to get ready to make decisions about your treatment.

The assessment helps us determine your course of treatment, and serves as a record of where you were when you started.  You may be re-assessed again at different points in your treatment. Re-assessment lets you and your doctor know how you are progressing.

You can expect assessment to take at least 20 minutes.

The quicker you get through the assessment, the sooner it will be decided whether or not you’re a candidate for methadone or suboxone treatment. The time it takes to accept you as a client typically takes 24 hours after the assessment.

Consent and the opioid treatment agreement

• Before you receive your first dose of methadone, you must sign a consent form that allows your name to be added to the Methadone Registry database of the College of Physicians and Surgeons of Ontario. This applies only to Methadone Clients.  Suboxone clients do not need to register. This information is kept solely to prevent clients from receiving methadone treatment from more than one doctor. Only a methadone-prescribing doctor may confirm that you are, or are not, receiving methadone treatment. No one else — not your employer, not the police, not welfare nor the children’s aid — has access to this information.
• We ask clients to sign a contract, often called a “treatment agreement.” This agreement states that you consent to treatment, and sets out the rules and expectations of your provider.

The treatment agreement defines policies regarding urine samples, drug use, photo ID, carry doses, threats, violent or criminal behaviour, and the consequences if you fail to follow rules. The agreement explains that if you show up at the clinic or pharmacy stoned or drunk, you will be asked to wait or to come back later before you can receive your dose. (This is a safety precaution, because methadone or suboxone mixed with other drugs can be lethal.)