A pregnant woman walks into a hospital in early labour. She feels nauseated and achy; her contractions are 20 minutes apart. There is more to her story than meets the eye. She is on methadone maintenance therapy (MMT) and wasn't able to pick up her daily dose at the pharmacy this morning. Although her story may be hard to believe she is one of the estimated 17,000 clients in Ontario currently receiving MMT. Methadone is a legal substitute therapy for patients addicted to opioids, such as heroin, and prescription narcotics like OxyContin.
For nurses who encounter MMT clients during the course of their work, the recently published Registered Nurses' Association of Ontario (RNAO) MMT guideline is a welcome resource. The guideline ensures that nurses have the latest evidence-based information to enhance their practice and strengthen and improve care for MMT clients.
The costs of untreated opioid addiction include health care, law enforcement, social assistance and loss of economic productivity. In the past, heroin has been the most commonly misused opioid in Canada however, that pattern is changing due to the increased availability of prescription opioids. "A lot of people think it's only street drug users who take methadone but that's simply not true. I've had clients... addicted to opiates after dental or back surgery," explains Janice Price, a public health nurse who contributed her expertise to this guideline.