Making the Choice, Making It Work by CAMH

Author:CAMH
Language: eng
Format: epub
Tags: SEL026000, MED102000, PSY038000
Publisher: Centre for Addiction and Mental Health
Published: 2016-11-11T05:00:00+00:00

Dealing with side-effects

Some people are troubled by the side-effects of OAT, and others barely notice them at all. That said, side-effects tend to be more of an issue early in treatment, and when you are on a higher dose. Side-effects also tend to be stronger with methadone than buprenorphine. Be sure to talk with your doctor about anything you are experiencing that might be a side-effect, and try some of the tips for each of the common side-effects listed below.

There are things to help with all side-effects: don’t give up. It may be time to look at where your dose is at, you may be plateaued too long, you may be up too high, you may need to go down—something needs to be played with.

Ann, 42 | Methadone, 2 years, 5 years

CONSTIPATION

Like other opioids, methadone and buprenorphine can cause constipation. Try to keep things moving by keeping active with any kind of exercise and by eating plenty of fruits, vegetables and other high-fibre foods. Prunes and prune juice are a good old-fashioned tried-and-true remedy. Beware of foods that are high in fat like cheese and pastries. These are harder to digest and tend to make your system sluggish.

If you’re not used to a high-fibre diet, go easy at first. Wash it all through with plenty of water. These foods can cause bloating and gas. Gradually your body will be able to process this diet without too much embarrassment.

If problems with constipation persist, talk to your doctor or pharmacist. The constipating effects of opioids are not something that people get used to with time. Use of regular laxatives is safe and may be needed. Fibre-based laxatives, (e.g., psyllium) are not recommended because they can increase constipation if not taken with enough water.

I wish I’d know that it binds you up, that you can’t go to the bathroom for days, sometimes a week, you get pains, sweating. It really hurts.

Paul, 57 | Methadone, 4 years

DRY MOUTH

Dry mouth is a common side-effect of many medications. To protect your teeth, follow the dental routine recommended for everyone: brush and floss every day, go to the dentist at least twice a year and cut sugar from your diet. Drinking plenty of water and chewing sugarless gum can also help to relieve dry mouth. If the problem persists, your pharmacist may be able to suggest products that can help.

EXCESSIVE SWEATING

This persistent symptom can be difficult to control. Sometimes, if you are on a high dose, lowering the dose may stop the sweating, although some people continue to experience this side-effect even on a low dose. There is a medication that can help to reduce sweating, although it may worsen constipation; ask your doctor if he or she would recommend it. Lighter, natural-fibre clothes, strong antiperspirant and baby powder help some to feel less humid.

I never sweated until I started methadone—not a drop! I was prescribed something for the sweating, and I just had to take it for a bit, until I was at the right dose of methadone, and then I was fine.

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