title: Too much or never enough: a response to Treatment of opioid disorders in Canada: looking at the 'other epidemic'.
abstract: Prescription opioid (PO) misuse is a major health concern across North America, and it is the primary cause of preventable death for the 18-35 year old demographic. Medication assisted therapy including methadone and buprenorphine, is the standard of care for patients with opioid-dependence. Moreover, both of these medications are recognized as essential medicines by World Health Organization. In Ontario Canada, the availability of medication assisted therapy has expanded substantially, with almost a ten-fold increase number of patients accessing methadone in Ontario in the past decade. In their manuscript, Fischer et. al. (2016), present a view that expansion of opioid maintenance therapy (OMT) has outpaced true patient need and alternate strategies should be considered as first-line treatments. Here, we present a countering perspective-that medication assisted therapy, along with other harm reduction strategies, should be widely available to all opioid-dependent people as first-line treatments.
authors.affiliation: Northern Ontario School of Medicine, 935 Ramsey Lake Rd, Sudbury, Ontario, P3E 2C6, Canada.
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Eibl
authors.affiliation: Northern Ontario School of Medicine, 935 Ramsey Lake Rd, Sudbury, Ontario, P3E 2C6, Canada.
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Morin-Taus
authors.affiliation: Northern Ontario School of Medicine, 935 Ramsey Lake Rd, Sudbury, Ontario, P3E 2C6, Canada. dmarsh@nosm.ca.|Canadian Addiction Treatment Centers, 13291 Yonge St., Ste. 403, Richmond Hill, Ontario, L4E 4L6, Canada. dmarsh@nosm.ca.
authors.forename: David C
authors.initials: DC
authors.lastname: Marsh
mesh_terms: D000701:Analgesics, Opioid; D002047:Buprenorphine; D006801:Humans; D008691:Methadone; D009864:Ontario; D009293:Opioid-Related Disorders
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; D008691:Methadone