Slow-release oral morphine, sold under the brand name Kadian, is a treatment for opioid use disorder used when methadone or buprenorphine hasn't worked well for you. It's prescribed and monitored by a physician as part of an ongoing treatment plan.
Slow-release oral morphine is a long-acting form of morphine taken once a day as a capsule. Like methadone and buprenorphine, it's used in opioid agonist treatment, which means it works on the same receptors as opioids like fentanyl or heroin to reduce withdrawal symptoms and cravings without producing the same high.
In Canada, SROM is most often prescribed under the brand name Kadian. It's swallowed once daily, and the slow-release formulation is designed to work steadily over the day rather than in a short, intense burst.
SROM is a second-line treatment. That means methadone or buprenorphine (Suboxone) are usually tried first, because there's more research behind them and they're available at most clinics. SROM is considered when those options haven't worked for you specifically.
This doesn't mean anything was done wrong on your part. Everyone's body and history with opioids is different, and it can take more than one attempt to find a treatment that fits.
Before starting SROM, a physician will go over your history with opioid use and past treatment attempts, including what happened with methadone or buprenorphine. This helps confirm whether SROM is an appropriate next step.
If it is, your dose is started conservatively and adjusted over your first visits based on how you're doing. There's no fixed timeline for this — it depends on your response and how your body handles the medication.
SROM treatment includes regular follow-up visits so your doctor can check how the dose is working, watch for side effects, and adjust the plan as needed. Urine drug screening may be used from time to time as part of monitoring, the same as with other opioid agonist treatments.
Your medication is dispensed through the pharmacy of your choice, following the arrangement your doctor sets out — this may include daily witnessed dosing at first, moving to take-home doses over time if things are going well. Physician visits for this treatment are covered by OHIP; medication costs depend on your drug plan, so it's worth asking your pharmacy about coverage.
Not every clinic offers SROM, since it requires specific experience prescribing and monitoring it as a second-line opioid agonist treatment. Addiction Clinic Toronto offers SROM assessments for people who haven't stabilised on methadone or buprenorphine and want to explore this option with a physician.
If you're currently in crisis or feel unsafe, please contact ConnexOntario at 1-866-531-2600 or call 911. For a non-urgent SROM assessment, you can reach the clinic to book a visit.
Call 647-748-1337 or email info@addictionclinictoronto.ca to book an appointment at 55 Dundas St E, Toronto. Phones are answered 9:00 am to 5:00 pm, seven days a week.
Need to talk to someone now? ConnexOntario is free, confidential and available 24/7 at 1-866-531-2600. If someone is in immediate danger or may be overdosing, call 911. Ontario's Good Samaritan Drug Overdose Act gives legal protection to people who call for help.