Pubdate: Fri, 03 Mar 2006
Source: Ottawa Citizen (CN ON)
Copyright: 2006 The Ottawa Citizen
Contact:  http://www.canada.com/ottawa/ottawacitizen/
Details: http://www.mapinc.org/media/326
Author: Jake Rupert
Bookmark: http://www.mapinc.org/find?136 (Methadone)

METHADONE CLINICS FACE SUPPLY CUT

Experts Fear Spike In Crime, Disease If Officials Can't Supply Drug 
Treatment Patients

Ottawa's two largest methadone clinics will lose their supply of the 
drug because of a recent decision by the Ontario College of 
Pharmacists, jeopardizing the programs for many drug treatment patients.

"If the supply stops, there's going to be some seriously messed up 
people," said Andrew Main, who runs Harvest House, a residential drug 
treatment facility for men charged with crimes.

"If the clinics close down, I think that would be horrendous," added 
Dr. Peter Garber who runs a methadone clinic in the Toronto area.

Dr. Garber explained that stopping treatments cold turkey would cause 
patients a host of physical and mental problems akin to heroin 
withdrawal, including irritability, abdominal and bone pain, diarrhea 
and sweating.

Dr. Garber and Dr. Philip Berger, chief of family and community 
medicine at St. Michael's Hospital in Toronto, said the public should 
be concerned. They said if patients don't get methadone -- which 
takes away their craving for illegal drugs and opiate-based 
painkillers -- they could end up plying the streets for drugs. The 
result will be more crime and disease transmission.

"They'll be back on the streets within a day or two," Dr. Berger 
said. "They'll share needles, do crimes to pay for their drugs."

Dr. Garber said those who operate the clinics "owe the community an 
assurance treatment will continue. They have to give their patients 
fair warning if there is a possibility they are going to close their doors."

Last week, the Ontario College of Pharmacists ordered the pharmacists 
who supply the treatment centres to stop shipping methadone because 
of alleged violations of the college's code of ethics and government 
regulations for dispensing. The pharmacists, Kitchener-based Wing and 
Susan Wong, dispute the charges. They must stop shipping the drug by March 13.

Yesterday, a college official admitted that backup supplies of 
methadone for the clinics' patients, including those in Ottawa, 
haven't been secured.

That has local addictions experts concerned.

The Ontario Addiction Treatment Centres are Ontario's largest 
methadone clinic group. The company, owned by Dr. Jeff Daiter and Dr. 
Michael Varenbut, runs methadone programs across the province, 
including two in Ottawa.

Mr. Main said he has one man at Harvest House using the clinic's 
methadone program. After 11 months, the man is on one of the lowest 
doses of methadone and is scheduled to quit altogether soon.

"I'm very glad he's almost finished," he said. "Earlier on in the 
treatment, it would have been devastating for him not to have had it."

The situation has doctors upset with the College of Pharmacists order 
to the Kitchener pharmacists to stop shipping methadone.

"It's an ethically unacceptable thing to do, without informing each 
and every patient of alternate sources of methadone and taking steps 
to ensure the patients have secured that source," said Dr. Berger of 
St. Michael's Hospital, who has been prescribing methadone for 15 years.

"I mean, there's 11 days left before this is supposed to take place. 
The pharmacy college should not be shutting down any supplier before 
making sure the patients' supply of methadone will be uninterrupted."

The allegations against the Kitchener pharmacists cover, in part, 
their business dealings and practices with the Ontario Addiction 
Treatment Centres clinics, including an Ottawa clinic on Somerset 
Street, owned by Dr. Daiter and Dr. Varenbut.

Last year, an Ottawa man died after a visit to the clinic. The dose 
he received at the clinic was 10 times the amount he could handle. 
The methadone used by the clinic was shipped from a Hanover, Ont., 
clinic that is alleged to be party owned by Mr. and Mrs. Wong.

The Ontario coroner's office is looking into the death and is 
expected to complete a report in the coming weeks.

In the meantime, officials at the College of Pharmacists have ordered 
the Wongs to stop shipping methadone. The college alleges, in part, 
that Mr. Wong "engaged in conduct ... that, having regard to all the 
circumstances, would reasonably be regarded as disgraceful, 
dishonourable or unprofessional."

The college is working to secure new sources of methadone for 
patients, but officials acknowledge no firm plan is in place.

The Wongs "have been given to March 13, because there's a 
responsibility to the patients to ensure a supply of methadone," said 
the college's deputy registrar, Della Croteau, herself a pharmacist.

"We have a number of pharmacists that have stepped forward and said 
they'd be willing to supply these patients."

Workers at the Ottawa clinics, who wouldn't give their names, said 
yesterday they don't know where the methadone supply will be coming 
from in the future, and that they've not been instructed to tell 
clients to start getting new prescriptions and looking for 
alternative pharmacists to dispense the drug.

But Dr. Garber said he didn't think patients are at any risk as long 
as Dr. Daiter and Dr. Varenbut are able to continue running the clinics.

And he sees no reason patients wouldn't be able to find pharmacists 
willing to dispense the drug, as long as the doctors are able to get 
them new prescriptions.

If there is any concern that this can't be done before March 13, Dr. 
Garber said the doctors need to come forward so patients and other 
doctors can solve any problems.
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MAP posted-by: Beth Wehrman