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Introduction: We present a 1-year program evaluation of the Medical Withdrawal Support Service (MWSS) provided at the Sioux Lookout Meno Ya Win Health Centre. The centre's service area includes 4 rural municipalities and 28 First Nations communities. The program involves inpatient detoxification for opioid dependence with the use of buprenorphine--naloxone. Methods: Data were collected from preadmission interviews (i.e., medical history, substance use history, previous counselling, social history, previous addiction treatment and screening tools used during the interview); discharge forms (i.e., length of stay, maximum dose of prescribed buprenorphine--naloxone and client goals); and postdischarge interviews. Results: Overall, 81% of the clients successfully completed the program. Two weeks after discharge, 48% of clients reported continued abstinence. At 3-month follow-up, 32% were abstinent, and at 6 months, 30% were abstinent. Conclusion: The MWSS shows positive outcomes for many clients, their families and communities. Clients returned to work and school, became more engaged in healthy meal preparation and exercise, spent more time with family and were more involved as leaders in their communities. [ABSTRACT FROM AUTHOR]