ANOTHER LOCAL DEATH LINKED TO MORPHINE

While community service agencies study establishing methadone treatment
locally, another sudden death in Sault Ste. Marie has been added to a
mysterious cluster the Ontario chief coroner's office is investigating as
morphine-related. A sudden death in June is now being looked at in relation
to 12 local deaths since October 1999, confirmed deputy chief coroner Dr.
Jim Cairns.

"It's being investigated, as they all are, in its own right, as a single
death, but it's also being investigated to see if there's anything
regarding the circumstances of that death that may tie in to the other
deaths," Cairns said Thursday.

Citing confidentiality rules, he would not reveal details about the victim
or circumstances of the death.

But he said some aspects of the latest death may "be of help in resolving
some of the issues" that have so far kept investigators from solving the
other 12 deaths. He expects firmer results in about a month's time.

"There are some similarities but that's all at this time it would be
accurate for me to say," he said.

"There are some things here that we may know more about than we did in some
of the others . . .

There's a line of inquiry that's ongoing that may be fruitful, but it's too
early to say."

One of the theories being pursued is whether the victims _ those confirmed
are 10 men and two women _ received morphine from the same source.

Cairns said investigators are no closer to confirming that but he hopes the
question will eventually be answered.

A few facts have emerged since April, when the chief coroner's office took
the investigation over from the regional coroner in northwest Ontario and
the Sault Ste. Marie Police Service to see if new patterns could be gleaned
from a different perspective.

As reported in January, morphine has been confirmed as the primary cause of
death in only one of the victims.

The drug has been attributed as a contributing factor to natural disease in
five other cases. Four of those were determined to have been prescribed
morphine legally for ailments such as chronic back pain.

In contrast to earlier suspicions, injection is not the preferred method of
administering the drug. Injection has been determined in only five cases so
far.

Six were found to be known drug abusers, and several of the victims, aged
between 30 and 50, were at least acquaintances.

Meanwhile, a committee of community service providers met for the first
time Wednesday to study the feasibility of methadone maintenance treatment
(MMT) in Algoma District to combat morphine addiction.

Traditionally, addiction to painkillers _ largely heroin but also morphine
_ has been treated through methadone, a synthetic opioid that helps
suppress withdrawal symptoms and can be regulated to prevent euphoric or
sedative side-effects.

According to the CAMH, the number of Ontario patients involved in MMT has
been increasing dramatically _ from 770 in January 1996 to more than 5,000
four years later.

But several communities, including the Sault, offer no methadone treatment
services outside correctional services.

The nearest centre is Sudbury, which has only one physician licensed to
prescribe methadone. As of June 2000, only 118 physicians were actively
prescribing methadone for the purposes of MMT in all of Ontario.

So far the committee has representation from the Centre for Addiction and
Mental Health, the Algoma Health Unit, the John Howard Society, Addiction
Treatment and Prevention Services of Algoma, Ontario Works, a local
pharmacist, a local family physician and a local provider of laboratory
services.

The committee is partly a result of a directive of the Ontario Substance
Abuse Bureau, an arm of the provincial health ministry that funds addiction
treatment agencies such as the CAMH.

The committee also grew out of the work of Addiction Treatment and
Prevention Services of Algoma, which in May released an information
pamphlet offering tips for safer injection drug use.

Committee chair and CAMH program director Mike O'Shea said the need for MMT
has been proven but recruiting a family physician here for that purpose is
a daunting task.

"It's more of a resource barrier to service, in terms of finding a
physician who might be interested in providing the service," he said.

"It's kind of a difficult sell to tell a physician who's already run off
his feet he should be looking at this kind of treatment."

He added that MMT involves more than just a physician _ a number of
community supports need to be established to methadone patients, such as
counselling and follow-up. He does not expect service this year, even if it
is determined to be feasible.