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There are addiction programs available in or near St. Paul Island which service both methadone and buprenorphine clients only, controlled medications which are dispensed in what is known as opioid maintenance therapy. Methadone is a full opioid agonist just like heroin, and buprenorphine is a partial agonist, meaning the same nerve cell receptors that make a person feel high from morphine or heroin are activated by these two drugs so therefore an opiate addicted client will instead no longer engage in addict behavior and won't experience withdrawal symptoms. There are risks of side effects, drug interactions, and even addiction and overdose with both methadone and buprenorphine, which is why they are highly regulated and can only be prescribed in a clinical setting.
Buprenorphine and methadone clients are on these medications consistently so they don't experience cravings, withdrawal, etc. but ideally at a dosage which isn't at the same time making them feel euphoria. Euphoria can be experienced at a high dosage, more significantly with methadone than buprenorphine. At programs that treat methadone and buprenorphine clients only, treatment therapies are generally limited beyond managing the medication and the primary treatment goal is to manage the withdrawal symptoms and put an end to the illicit drug use. Some programs do provide a small amount of counseling and therapy as secondary treatment, and this is encouraged.
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