Mayor asked to support methadone program

Police Chief Bob Davies wants it. So do Sault Area Hospitals, the Algoma Health Unit, the John Howard Society, local addiction agencies, and others.

It seems the only ones hesitant to get involved in a local methadone treatment program for opioid addicts are the people most needed to make it happen -- local physicians.

On Monday night, Mayor John Rowswell and City Council will be asked to throw their weight behind the drive for methadone treatment in the Sault.

And if local doctors won't rise to the challenge, the City's being asked to make willingness to prescribe methadone a priority in physician recruitment. What is it?

Methadone is a synthetic drug that's taken orally as a substitute for opioid narcotics (opium, morphine, etc.) derived from the seed pod of the poppy plant (shown above). It's also used to treat addiction to simiilar synthetic and semi-synthetic narcotics including heroin, Dilaudid and Percodan.

Methadone is itself a narcotic. When used in opioid addiction, it cuts down on craving, reduces withdrawal symptoms, and does so without causing sedation or euphoria (exaggerated feelings of happiness or well-being).

"To date, methadone is considered one of the most effective treatment modalities for some individuals who are addicted to opioids," says Mike O'Shea, chairperson of the local Methadone Maintenance Steering Committee.

International 'gold standard'

Canada's Drug Strategy, a federal white paper released last year, went considerably further, describing methadone as the international "gold standard" for treating opioid dependency.

"It has been shown to improve health status, increase employment, improve pregnancy outcomes, decrease opioid use, the use of other drugs, crime and incarceration, and have a positive economic effect on society," the white paper said.

The white paper also pointed out a further benefit -- untreated addicts were four times as likely to be HIV-positive as their methadone-treated counterparts.

In Canada, physicians must have a special exemption under the Controlled Drugs and Substances Act before they can prescribe methadone.

Physicians often misinformed

"Many physicians are reluctant to prescribe methadone for opiate dependency because of issues such as stigma, lack of experience in the field of addiction, and in rural communities, the feeling of being isolated from other essential services," the white paper said.

In his 1995 book, Methadone in the Treatment of Narcotic Addiction, Australian general practitioner Andrew Byrne says many medical doctors suffer from methadone misconceptions.

"Erroneous beliefs include the concept that few patients ever come off treatment successfully; that those on high doses have a more serious addiction problem; or that the treatment is not based on sound Hippocratic principles," Byrne wrote.

Suspicious of drug addicts

"Some medical practitioners are suspicious of drug addicts due to past deceptions of some narcotic-seeking patients. This cycle of mistrust will only break down when the medical profession is able to treat addictions in the same way as it treats other chronic relapsing conditions such as osteoarthritis, diabetes, obesity, infertility and depression," Byrne said.

The medical literature also hints at considerable friction between methadone advocates and those who prefer traditional 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous, or counselling that addresses the causes of addiction.

Sault doctors disinterested

Here in the Sault, Mike O'Shea and his methadone steering committee have been unsuccessful in getting local doctors interested in methadone treatment.

He brought in Wade Hillier, coordinator of the Mayor's Task Force on Drugs in Toronto, to speak to Sault physicians about the importance of setting up a program here.

"Unfortunately, none of the doctors who attended the recruitment night expressed an interest in becoming involved," O'Shea recalls.

Closest methadone treatment is in Sudbury

According to the most recent numbers from the Centre for Addiction and Mental Health, the Sault has 235 individuals with identified opioid problems. That represents only those who have presented themselves for local detox and addiction counselling services. The number doesn't include addicts who instead go to the hospital emergency department or to the needle-exchange program.

Except for persons incarcerated at the Northern Treatment Centre, the closest methadone treatment program available to Algoma residents is in Sudbury, where O'Shea says the program is unable to meet local demand, never mind an influx of clients from Algoma.

Tony Martin supports treatment here

Sault MPP Tony Martin, who supports methadone treatment in the Sault, says his office has received several calls in recent months asking for information and help with travel expenses related to methadone programs in Barrie and Englehart.

At the beginning of treatment, weekly consultations are needed for the first few months.

Northern travel grants cover only the cost of seeing specialists, not the general practitioners who are most likely to participate in methadone treatment.

Coronor investigating morphine-related deaths in Sault

Meanwhile, Dr. David Legge, regional coroner for Northwestern Ontario, discloses that he's conducting a "cluster death investigation" involving Sault-area residents over the past two years.

"There have been a number of deaths involving opiate addicts where drugs such as morphine are involved in the mechanism of death," Legge says.

"Each of these cases is unique unto itself, but nonetheless the coroner's office has a strong mandate to promote public safety and it follows logically that development of a methadone maintenance treatment program would be a great benefit to your community," Legge says.

What they want Council to do

Here's what O'Shea's committee is asking Mayor Rowswell and City Council to do:

- add the voice of the Mayor and Council, by writing to the Ontario Ministry of Health and Long-Term Care asking for the needed funding to establish a methadone treatment program in the Sault.

- emphasize the need to attract to the Sault physicians who are licensed or willing to become licensed to prescribe methadone

- appoint a member of City Council to the Sault's Methadone Maintenance Steering Committee

Give it a try, or let them fry?

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