Methadone treatment for patients who use fentanyl: Recommendations

This document was initiated to address specific issues related to methadone prescribing, dose titration, and treatment retention in the context of the fentanyl crisis. The recommendations are based on the premise that clinical decisions should have the overarching objective of promoting patient engagement and retention in treatment, as duration of treatment has been shown to be a crucial predictor of outcomes. This is not an exhaustive review of all aspects of methadone prescribing. Although the CPSO discontinued its methadone policy, program standards, and guidelines in March 2021, these continue to inform the practices of Ontario prescribers who were expected to adhere to the guidelines as a standard of practice against which they would be explicitly assessed.