COLLEGE DISCIPLINES DOCTOR FOR 'DRUG PLAN'

Prescribed Narcotics To Addicts As Part Of 'Harm Reduction'

TORONTO -- An Ottawa doctor who prescribed narcotics to addicts rather than
have them score drugs on the street was declared incompetent yesterday by
the College of Physicians and Surgeons.

Dr. Dan Sweet, 48, admitted prescribing opioids -- a family of strong pain
relievers that includes morphine and codeine -- to patients as part of
their addiction therapy.

His lawyer, Charles Hackland, told a four-member disciplinary panel it was
part of the doctor's "harm reduction" program.

Harm reduction is an international movement to decriminalize and
destigmatize drug use in favour of practical measures, including needle
exchanges and the distribution of methadone to heroin addicts, to help
users live as normal a life as possible.

"What (Dr. Sweet) was attempting to do in his program was encourage people
who were opioid addicts to step out of the criminal milieu, out of the
streets, by prescribing them opioid medications," hopefully tapering their
dosages off, Mr. Hackland said.

"From his perspective, he had considerable success with his approach."

Dr. Maureen Pennington, an expert in addiction psychiatry from the
University of Western Ontario in London, reviewed both Dr. Sweet's records
and photos of his Hunt Club Road office for the college.

In a report, she called the prescribing of non-methadone drugs to addicts
"questionable" and said while Dr. Sweet's intentions were good, he was not
careful to prescribe low doses and he failed to be sufficiently aware of
overdose risks.

His inadequate control of the drug supply was mirrored by the "physical
chaos" of his office, which was so disorganized that patient charts were
lost, she said.

His "careless prescribing practices" put his patients and others at risk,
Dr. Pennington concluded.

In return for the guilty plea to incompetence, two other misconduct
allegations were withdrawn. The college indefinitely extended its July 2001
interim order that he be stripped of his right to prescribe drugs.

Dr. Sweet also signed a statement that he accepts Dr. Pennington's
findings. His lawyer said he admits he "crossed the line."

However, in a brief interview with the Citizen moments after the hearing,
Dr. Sweet rejected Dr. Pennington's findings.

He suggested he pleaded guilty rather than incur the "enormous" cost,
travel and time required to fight the college.

"I disagreed with the report that was brought forth. I didn't present any
challenge at the advice of counsel. It's just the way things go in the
province today," he said.

When asked if Ontario needs more harm reduction programs, he replied: "Oh,
big time."

He also said a long waiting list for the methadone program that saw
Ottawa-area patients sent to Kingston and Toronto was part of the reason he
acted.

Dr. Sweet can apply to the discipline committee one year from now to have
his prescribing privileges reinstated. Mr. Hackland said the doctor, who
intends to continue providing addiction counselling, will make an
application sometime.

The three-man, one-woman disciplinary panel was never told Dr. Sweet is a
former prescription drug addict who ordered himself narcotics while chief
of anesthesiology at Cornwall General Hospital. Nor did it hear he once
almost killed himself by mistakenly injecting a muscle relaxant.

Dr. Sweet kicked the habit after stints in drug rehabilitation in Toronto
and Atlanta and then started counselling others.

Neil Perrier, the lawyer who represented the college at yesterday's
hearing, said the panel was left in the dark about Dr. Sweet's past drug
abuse because it was not relevant to the allegations.

Dr. Sweet was also ordered to display a sign in his office telling patients
he can't prescribe drugs, and to pay the $2,500 cost of the hearing. The
college's quality assurance committee is to monitor his standard of care.

Walter Cavalieri, a Toronto social worker and part of the Canadian Harm
Reduction Network, said he was unaware of Dr. Sweet's case. However, he
agreed Ontario has been slow to adopt progressive approaches to drug
treatment. Pressure from the U.S. and its penalty-driven war on drugs is
largely to blame, he said.

"Maybe we need a harm reduction structure within the college to at least do
some controlled experiments" involving different drugs, said Mr. Cavalieri,
who is also a researcher at the University of Toronto faculty of medicine.