Notes from the clinic

Plain, practical writing about opioid agonist treatment in British Columbia. Written for patients and families rather than for other clinicians, and reviewed by our prescribing physicians.

Starting treatment

What actually happens in your first week on methadone

The first week is the part nobody explains properly, and it is the week most people quit. Here is an honest account of what to expect, day by day, and why feeling rough on day three is not a sign that treatment is failing.

14 July 2026·7 minute read

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About these articles

Written and reviewed by prescribing physicians
Reflects current British Columbia clinical practice
Written for patients and families, not for clinicians
Updated when provincial guidance changes

Methadone or Suboxone: how the choice actually gets made

Both are first line treatments and both work. The decision comes down to your tolerance, your schedule, and what you have already tried, rather than one being better than the other.

23 June 2026·6 minute read

Take home doses explained: how carries actually work in BC

Carries are the point at which treatment stops running your week. Here is what decisions are based on, roughly how long it takes, and what causes them to be paused.

30 May 2026·5 minute read

How to help someone who is not ready for treatment yet

The hardest position is caring about someone who has not decided to change. What the evidence says about what helps, what makes things worse, and how to stay in contact without losing yourself.

8 May 2026·6 minute read

Editorial policy

How this blog is written

Everything here is written or reviewed by our prescribing physicians and reflects current practice in British Columbia. We aim to be useful rather than reassuring, which sometimes means saying that a treatment has real drawbacks. Nothing on this blog is a substitute for an assessment.

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