Pubdate: Mon, 15 Nov 2010
Source: London Free Press (CN ON)
Copyright: 2010 The London Free Press
Authors: Michelle Hurtubise and Linda Sibley
Note: Michelle Hurtubise is executive director of the London 
InterCommunity Health Centre. Linda Sibley is executive director of 
Addiction Services of Thames Valley.


The city is investigating zoning regulations for methadone clinics. 
As local agencies that serve individuals benefitting from methadone 
treatment, we are compelled to contribute to the community 
conversation about this issue.

 From the dialogue we've overheard and the comments we've read, it 
appears there is much misinformation circulating about methadone and 
the benefits it offers individuals struggling with addiction.

Methadone is a legal synthetic opioid drug often prescribed as an 
effective treatment for those trying to conquer addiction to heroin 
and other narcotics. At a certain stage in their addiction, it is not 
the "high" that users seek from narcotics. It is avoidance of the 
discomfort of withdrawal that keeps them using. Methadone does not 
give the user a "high" as other narcotics do, but it does provide 
relief from withdrawal symptoms.

Methadone may also be prescribed as a chronic pain management tool 
for individuals who cannot get relief from other narcotics.

The city's planning documents refer to only one methadone clinic 
located in the east end of London. There are, in fact, at least four 
other methadone treatment clinics in London. Each clinic has a 
slightly different emphasis of care, a different clientele and a 
different way of managing the flow of patient care.

As the city considers planning restrictions on methadone clinics, it 
would benefit from reviewing the practices and locations of more than 
just London's most high-profile location. It is important to consider 
not only the locations about which complaints have been made, but 
also the locations where there are not.

Furthermore, there is confusion regarding the distinction between 
methadone treatment clinics and pharmacies that dispense methadone. 
The right for a pharmacy to dispense methadone is a provincial 
licensing issue, not a zoning issue. There are eight known pharmacies 
in London that dispense methadone with minimal impact on their neighbourhoods.

Beyond these considerations, the comments from city politicians and 
community members -- such as "the addicts are the ones who decided to 
go on the stuff in the first place" -- further stigmatize individuals 
trying to break free from their addictions. The source of their 
addiction isn't at issue here; their treatment is.

Furthermore, clients have not made a conscious choice to become 
addicted to narcotics or any other substance; this is a preposterous 
notion. It is often said in addiction treatment that the addiction 
chooses you, you do not choose it.

Methadone maintenance treatment is an essential component of 
addiction treatment in Ontario and other international jurisdictions.

There is hope and healing from addiction, and we see it every day. 
The lives of substance users should not be made any more difficult by 
misconception, misunderstanding and stigmatization.

In some cases, a prescription for methadone is a vehicle for becoming 
completely drug-free. The prescription assists the user to develop 
drug-free habits and a new lifestyle. Methadone affords an 
opportunity to become stable and begin to contribute to the community 
again. In these cases, the user of methadone might be weaned off the 
medication at a later point when triggers for relapse are less and 
their lifestyle is stable.

Other users of methadone may use their prescription for the rest of 
their lives, just as cholesterol or diabetes medication might be 
used. The medication allows a return to stable living and addiction 
is seen as being "in remission." Access to the right treatment in the 
right location is critical. Hospitals are not the only location where 
treatment should occur -- as has been proposed by a number of 
individuals in online comments to The London Free Press.

Across the health-care system, the trend is to move services out of 
the hospitals and locate them in community-based settings so that 
they are more easily accessible from our homes and places of 
employment. This should be the case for methadone treatment clinics as well.

Ontario has a full continuum of addiction care services available 
across the province. While there is a need for increased services to 
assist persons with addictions at an earlier point, there is 
excellent treatment available across Ontario and in London 
specifically. We are fortunate to have increased access to methadone.

Michelle Hurtubise, Linda Sibley
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