Pubdate: Wed, 05 Apr 2006
Source: Sault This Week (CN ON)
Copyright: 2006 Osprey Media Group, Inc.
Contact:  http://www.saultthisweek.com/
Details: http://www.mapinc.org/media/2398
Author: Sandra Hodge 	
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

INTERIM MOH POLICY ALLOWS NURSES TO GIVE METHADONE

An interim Ministry of Health policy now permits nurses at the 
Sault's Addictions Treatment Centre to administer methadone.

Worried patients, concerned during the past few weeks about their 
ongoing methadone treatments, have compelled governing bodies to 
change the rules.

Methadone is a synthetic drug used in addiction treatment programs to 
help stabilize the lives of people previously addicted to heroin, and 
other opioid drugs including narcotic prescription pain relievers 
such as OxyContin.

A March 15 notice posted on the Ontario College of Pharmacists' web 
site announced that "the interim policy was developed in 
collaboration with the College of Physicians and Surgeons of Ontario 
and in consultation with Health Canada with the view to permit a 
methadone maintenance treatment (MMT) model in Ontario that meets the 
needs of patients..."

Under this new policy, according to the OCP, pharmacists can transfer 
custody of the drug to a physician or their delegate (qualified 
person) provided that physician has applied for and been granted a 
new exemption by the College of Physicians and Surgeons of Ontario.

In 1996, the College of Physicians and Surgeons of Ontario (CPSO) 
began to administer the provincial methadone program on behalf of the 
Ministry of Health and Long-Term Care in cooperation with the Centre 
for Addiction and Mental Health and the Ontario College of Pharmacists.

As such, pharmacists are accountable under the Drug and Pharmacies 
Regulations Act and to the Ontario College of Pharmacists while 
physicians are accountable to the College of Physicians and Surgeons 
of Ontario.

The two colleges will collaborate on the development of a joint 
policy to ensure adequate accountability within this non-traditional 
approach to the provision of methadone while engaging in a process to 
review the interim policy.

As well, the two colleges will be issuing, to pharmacists and 
physicians involved in the provision of methadone, a document 
outlining Fundamental Assumptions relating to methadone provision 
which sets out the expectations of both Colleges for this area of practice.

Deanna Williams, registrar for the OCP, said the interim policy 
assures patients who require methadone maintenance programs access to 
the treatments they need and that pharmacists have more options in 
providing care to patients.

The interim policy is considered a win by Ontario Addictions 
Treatment Centre co-founder Dr. Jeff Daiter. In a STW interview last 
month, Daiter insisted that his Queen Street methadone clinic in the 
Sault -- along with 31 others in the province -- is a more 
appropriate venue than a public pharmacy to treat patients. He called 
it "an absolute insult to the nursing profession" that they were not 
recognized by existing OCP policy as qualified to dispense methadone.

Daiter said nurses have been dispensing methadone in the Sault clinic 
all along, under the direction of Dr. Chris Bruni and Dr. Lino Pistor.

Daiter's clinics have been under some fire recently for their 
apparent connection with Wing and Susan Wong -- a Kitchener based 
pharmacist couple -- who, according to some reports, had exclusive 
rights to supply methadone and other drugs to the OATCs in exchange 
for financial investments in the clinics.

The Ontario College of Pharmacists had imposed a March 13 deadline to 
"shut down" the so-called "methadone pipeline" from sanctioned Wong 
pharmacy whose nine-point discipline referral begins with "failure to 
maintain a standard of practice". Earlier reports in the Toronto Star 
described the Wong pharmacy as a "factory" from which boxes of 
methadone were shipped regularly to OATC clinics across the province.

On March 16, 2006, though, the Ontario College of Pharmacists 
rescinded the sanctions against Wong, given his "undertaking" to 
comply with all terms and conditions of the interim policy.

OCP registrar Deanna Williams said she could not comment on the 
Wongs' case as it was still under investigation, but she did confirm 
that the Ontario College of Pharmacists had been approached -- and 
has agreed -- to sit on a Government of Ontario task force to 
investigate the Province's methadone dispensing system.

Ministry of Health and Long-term Care spokesperson John Letherby, 
though, would not verify that such plans were in the works, saying it 
was "premature to give a go-ahead or a blessing to the possibility of 
a task force yet."

Letherby insisted that all options were being considered to ensure 
that the "best practices for the safe delivery and safe supply" of 
methadone were being provided to the patients who depend on it for 
their maintenance programs. He could not say what, if any, options 
other than a possible task force were being considered by the 
Ministry to address how best to ensure methadone treatment programs 
are monitored.

Meanwhile, according to the Toronto Star, OATC lawyers are awaiting 
word from the courts.

Monday they sought to have a Newmarket hearing date set to "quash" 
three OPP warrants issued last November investigating the clinics.
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MAP posted-by: Beth Wehrman