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