Helping people describe how opioid treatment feels
SODA is a simple check-in that helps you reflect on how your opioid treatment feels day to day and prepare for a conversation with your care team. It takes about 5–10 minutes. SODA does not recommend medication or dose changes
What is SODA?
SODA (Stability of Opioid Dose Assessment) is a short, structured check-in for people receiving opioid substitution treatment, to help you describe your experience of treatment.
SODA is
- A short check in about your opioid treatment
- A way to describe withdrawal, craving, use of other opioids and missed doses.
- A simple score and feedback band based on your answers.
- A way to help you think about what to discuss with your care team.
SODA does not
- Recommend medication or dose changes.
- Tell you what dose to take.
- Tell your prescriber what to prescribe.
- Diagnose you.
- Replace your prescriber or treatment team.
- Give emergency help.
Why SODA?
Despite decades of evidence, there is no simple way to structure how people describe whether their opioid medication feels like it is working well enough day to day. SODA fills that gap by providing a 5-minute check-in embedded within the consultation.
Existing tools look backwards
NDTMS and similar systems show what happens over time. They are useful for monitoring outcomes, but they do not help structure real-time conversations about whether medication feels stable today.
Instability can go unseen
People may remain in treatment while still experiencing withdrawal, craving or ongoing opioid use between reviews. Without a simple structured check, this can be missed or discussed too late.
Missing instability has consequences
When treatment does not feel stable, people are more likely to disengage, use additional opioids, or face increased overdose risk — especially at times when extra support may be needed, such as release from prison.
How to think about your score
SODA gives a score from 0 to 20. The score reflects how stable your treatment feels right now. A higher score means you may be experiencing more withdrawal, craving, ongoing opioid use, or other difficulties between doses.
This does not automatically mean your dose should change. Many things can affect how treatment feels, including missed doses, other drug use, stress, sleep, physical or mental health, recent changes in treatment, or how long you have been in treatment. Your score is there to help you and your care team have a clearer conversation about what may be going on.
Your SODA score reflects your experience of treatment. It is not a diagnosis. It is not a dose recommendation
Stable
Treatment working well
Mostly stable
Some gaps possible, worth discussing with your team.
Moderate instability
A conversation with your prescriber may be useful.
High instability
Important to discuss with your prescriber soon
Important
- SODA is a reflection and conversation tool.
- It does not diagnose, treat, or tell you what medication to take.
- All prescribing decisions stay with your prescriber.
- Do not change, miss, increase, or reduce your medication because of a SODA score.
- If you feel very unwell, very sedated, confused, at risk of overdose, or in immediate danger, get medical help now.
Stable vs Not Stable in Treatment
STABLE
- No withdrawal between doses
- Not thinking about using
- Not using on top
- Not missing doses
What this means:
Your treatment is working well — helping you feel stable and in control.
NOT STABLE
- Withdrawal between doses
- Thinking about using
- Using on top
- Missing doses
What this means:
You could be getting more from your treatment — it might be worth talking to your prescriber.
Lots of things affect how you feel — but your medication is one part we can improve together.
Ready to get started?
Start your SODA check-in. It takes 5–10 minutes and gives you a simple score you can share at your next appointment.
