People First Radio – October 16, 2025People First Radio – October 16, 2025
People First Radio
Two addictions medicine specialists explain how opioid agonist treatment works, why it is considered the gold standard for opioid use disorder, and how stigma, toxic drug supplies and limited stimulant treatments complicate recovery. The conversation focuses on practical realities, safety, access and the idea of opioid use disorder as a chronic medical condition.
0:00•17 Oct 2025
Opioid Agonist Treatment: Medications, Myths and Life Beyond Withdrawal
Episode Overview
- OAT medications such as methadone, buprenorphine and slow-release oral morphine are described as the gold standard for reducing overdose deaths and improving quality of life in opioid use disorder.
- These long-acting medications stabilise opioid receptors, prevent withdrawal and cravings, and can make space for people to work, study and rebuild relationships.
- Access to OAT in British Columbia is widespread, free at point of care, and supported by a provincial phone line, yet many people who qualify are still not in treatment.
- Stigma and misconceptions – including the idea that being on OAT means someone is “not really in recovery” – are highlighted as major barriers that stop people seeking support.
- The toxic drug supply, widespread stimulant involvement, benzodiazepine contamination and limited tools for stimulant use disorder create new challenges that current systems and treatments are struggling to keep up with.
“When we stigmatise things, when we force them into dark corners, it doesn't shame people out of using drugs. It shames people out of accessing support.”
How do people find strength in their journey to sobriety? This episode of People First Radio takes a practical, science-based look at opioid agonist treatment (OAT) and what it actually means for people trying to live with, or away from, opioids. Host Joe Pugh speaks with Nanaimo-based addictions medicine doctor Dr Jess Wilder and Vancouver physician and researcher Dr Paxton Bach.
Together, they break down OAT in clear, everyday language, explaining medications like methadone, buprenorphine (Suboxone, Sublocade) and slow-release oral morphine.
As Dr Bach puts it, these medications are “the gold standard in treatment for opioid use disorder… by far the best medications we have at reducing risk of overdose death.” You’ll hear how OAT works in the brain, why long-acting medications can “give someone back their day”, and how they let people work, study and raise families while staying out of withdrawal.
The episode doesn’t shy away from the tough parts either: daily pharmacy visits, rules around methadone, and the very real stigma people face. Dr Wilder points out that stigma “doesn’t shame people out of using drugs. It shames people out of accessing support.” The conversation widens to the toxic drug supply, accidental fentanyl exposure, and the rise of stimulants and benzodiazepines in overdose deaths.
Dr Bach explains why stimulants are involved in over 80% of overdose deaths and why evidence-based tools like contingency management are still so hard to access. This one’s especially useful if you’re curious about medication-assisted treatment, supporting someone on methadone or Suboxone, or trying to understand why OAT is framed as a long-term treatment for a chronic condition rather than a quick fix.
It’s honest, practical and quietly hopeful – the kind of discussion that might help you see OAT, and recovery, in a very different light. So, what might change for you if medications like these were seen as just another part of healthcare, rather than something to be ashamed of?
Do you want to link to this podcast?
Get the buttons here!
More From This Show
The latest episodes from the same podcast.
Related Episodes
Similar episodes from other shows in the catalogue.