Pubdate: Tue, 13 Sep 2005
Source: Penticton Herald (CN BC)
Copyright: 2005 The Okanagan Valley Group of Newspapers
Contact:  http://www.pentictonherald.ca/
Details: http://www.mapinc.org/media/664
Author: Joyce Langerak and Mark Brett
Bookmark: http://www.mapinc.org/coke.htm (Cocaine)
Bookmark: http://www.mapinc.org/find?143 (Hepatitis)
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/meth.htm (Methamphetamine)

TREATMENT TOUGH ON DOCTORS

Editor's note: This is the first in a series of articles about substance 
use and rehabilitation issues in the Penticton and South Okanagan area.

Dr. Lloyd Westby has had enough. Having treated as many as 80 heroin 
addicts at a time for more than a decade, the Penticton physician plans to 
write his final methadone prescription Dec. 16

"I'm quitting; I'm burnt out," said Westby, who has worked with drug 
addicts, including those in Vancouver's notorious east end, since 1992

"I'm going to take a break. It's too much work. It's too hard. Someone 
who's a heroin addict -- they have no money. They have no transportation. 
They frequently have nowhere to live. They have no food. They have no 
toothbrush, no dental care. You can see why it would be difficult to care 
for these persons." It's not that he dislikes the people he treats, but 
more what the drug has turned them into

"I very much like this population of people," said Westby, who opened his 
practice in Penticton in 2002. "They're survivors by definition. They're 
wonderful people. They really are. It's like a family on the street. 
They're extremely appreciative for the most part." He began prescribing 
methadone for the local program about three years ago after Dr. Cheryl 
McDermid of Penticton made the methadone service available to local addicts

She quit medicine about three years later

"So that left this clinic at the Penticton Health Centre without a 
physician," said Westby. "I said I would take it over, but I would just do 
it out of my office. It's complicated work to deal with street people with 
serious addictions." He added that many also have hepatitis C, HIV and a 
lot of psychological trauma. And, almost without exception, such addicts 
have suffered childhood abuse

"Probably 80 per cent of them have criminal records," Westby said

One of the doctor's biggest concerns was the difficulty in finding another 
physician to operate the program locally, something he had been trying to 
do himself

"There is no one else who wants to take over," Westby said as his cellphone 
rang

Calling was one of his methadone patients. He spoke to her for several minutes

"I've got lots of people extremely angry with me, and threatening me," he said

Some prostitutes have threatened to contact the College of Physicians and 
Surgeons to register phoney complaints of sexual abuse against him

He's also spent about $10,000 of his own money on the project

"When I try and entice other people to get involved, it's hard to sell a 
package that involves harder work for less pay," he said

Westby is paid much less for visits by methadone users than for a regular visit

"There is no rationale behind these things," he said

Subsequent to the Herald's interview with Westby, Dr. Jennifer Rice, 
Okanagan medical health director for Interior Health, said another 
physician has been found to continue the program

"I understand Dr. Westby's feelings. Physicians do burn out. No question 
- -you're dealing with a very difficult population," she said

"We have found a replacement for Dr. Westby, who has provided stellar 
service, so there will be no interruption in the program. "There is no 
question that the program works. It may not work for everybody, but I would 
say that it does for the vast majority, and we do care very much about 
keeping it going." Methadone works for opiate addiction, but not for 
crystal meth and cocaine addictions. The latter drugs are amphetamines

Opiate addictions that respond to methadone include morphine addiction, 
Dilaudid, Percocet and codeine. Even though he is ending his involvement 
with the program, at least temporarily, Westby believes it is effective

"I've saved more life by prescribing methadone than dealing with cardiac 
arrest by a long shot," he said. "It's a good thing. This is actually an 
incredible saviour to many people. Access to this service should be 
available in every community." People can stay on methadone for years, and 
it helps them live a normal life. Many remain on the drug and don't even 
try to quit, although the purpose of the program is to gradually end their 
dependency on all drugs

"I have people who drive semi trucks who are on methadone (as regulated by 
the Motor Vehicle Branch)," said Westby

Most of those on the program take methadone at a drug store under "daily 
witnessed ingestion" as the pharmacist watches. However, under some 
doctorapproved situations, users are allowed to "carry" amounts of the drug

Westby is hopeful Health Canada will soon approve Buprenorphine, a drug 
that allows people to get off methadone and other opiates. But while some 
people are being rescued from the grip of heroin, it seems many more are 
succumbing to its deadly vice

"Now, it's more available," said Westby. "It's purer. The price has gone 
down. It's a changing landscape."
- ---
MAP posted-by: Elizabeth Wehrman