Pubdate: Sat, 21 Oct 2006 Source: Abbotsford News (CN BC) Copyright: 2006 Abbotsford News Contact: http://www.abbynews.com/ Details: http://www.mapinc.org/media/1155 Author: Cheryl Wierda EXPERT IN ADDICTION MEDICINES TESTIFYING The trial of James Swanney - the former Abbotsford doctor charged with criminal negligence causing the death of patient Christena Constible in 2000 - continued Tuesday with an expert in addiction medicines testifying about normal practices for prescribing methadone. Dr. Garth McIver, who has been involved with methadone maintenance for approximately a decade, testified that the preferred method of giving methadone to patients is by way of a "direct, witnessed ingestion by a pharmacist." He also testified that methadone, which is typically a powder mixed with a liquid for treatment of drug addiction, is commonly mixed with Tang, giving it an orange colour. He said he "had not" ever heard of methadone being green. Doctors who prescribe methadone must receive an exemption from the federal minister of health under the controlled drug and substances act, he said. That exemption allows doctors to administer, prescribe, buy or sell methadone to patients. However, he said pharmacists normally dispense methadone, and testified Tuesday that he is not aware of any doctors in the Lower Mainland that dispense methadone from their offices. In previous hearings into Swanney's care of Constible, it was heard that on May 11, 2000, Swanney gave Constible methadone that had been returned to him, and she swallowed the contents of one vial in Swanney's office. Swanney gave Constible a second vial to take home. She died that night. Swanney also testified at the inquest into Constible's death that the methadone he gave to Constible that day was pale yellow to orange in colour, which conflicted with evidence presented by her mother, who said it had been an unusual green colour. McIver also testified that the anxiety Constible said she was experiencing approximately 10 days after she finished taking methadone in March 2000 are consistent with methadone withdrawal. He also said it is possible to experience methadone withdrawal up to three weeks after halting use of methadone. He said drugs like benzodiazepine and valium are sometimes prescribed for anxiety and insomnia involving patients experiencing withdrawal, and testified Paxil, which Constible reported receiving from Swanney, would have "minimal" effect for treatment of withdrawal symptoms. That prompted objections from defence lawyer Terry Robertson, who said Constible's cause of death did not involve Paxil. He argued it was irrelevant to the case that Swanney gave Constible Paxil and said it may be prejudicial to Swanney's case if the witness disagreed with Swanney's decision to give the drug to Constible. The trial continues in B.C. Supreme Court in New Westminster. - --- MAP posted-by: Elaine