DOCTORS CALL METHADONE KICKBACKS A 'BIG PROBLEM'

Nearly $18 Paid For Each Methadone Dose Dispensed

Addictions doctors in Vancouver's Downtown Eastside have complained
for months about pharmacists luring heroin addicts for their
lucrative methadone prescriptions, and say rules around dispensing
fees have to change.

"A lot of doctors have been frustrated by this," said Dr. Stan
deVlaming, medical director for Inner City Primary Health Care for
Vancouver Coastal Health Authority. "There have been numerous
complaints spread over months for at least a year. . . It's a big
problem, not a small one."

Heroin addicts prescribed methadone, which quells cravings, are
getting kickbacks for filling their prescriptions at certain
pharmacies, particularly in the Downtown Eastside and in Whalley's
downtown in Surrey.

Offering incentives is against PharmaCare rules and the B.C. College
of Pharmacists and B.C. Health are investigating.

Addicts must pick up their methadone doses daily. It's a lucrative
business for pharmacists, who collect $8.60 in daily dispensing fees
and $7.70 for witnessing the ingestion, in addition to the $1.40 in
reimbursement for the drug.

Supplying the 8,400 methadone users in B.C. could cost taxpayers up
to $54 million a year.

Dan Russell, 31, a construction worker prescribed methadone for about
six months a year ago, said he was paid $5 to $10 and sometimes $20
for patronizing a certain pharmacy. He said he could get it delivered
and no one would know if he ingested it.

DeVlaming said pharmacists have also urged methadone users to ask
doctors for daily doses of other drugs, including Tylenol or
ibuprofen, to collect daily dispensing fees.

If the doctor objects, the pharmacists counsel the patient to change
doctors, he said.

DeVlaming said the methadone maintenance program should be revamped.
He also suggested having government-run pharmacies to serve users.