B.C. PHARMACIES UNDER INVESTIGATION FOR GIVING DRUG ADDICTS CASH INCENTIVES

VANCOUVER -- Pharmacies that offer cash incentives to drug addicts
for their daily methadone prescriptions are under investigation by
the B.C. College of Pharmacists and PharmaCare, the provincial
government's drug-insurance plan. "I can confirm that we have an
active investigation ... but I am not in a position to reveal any
details," Lori DeCou, a college spokeswoman, said yesterday in an interview.

Bernadette Murphy, a spokeswoman for PharmaCare, said the provincial
agency was working with other authorities.

"The investigation has been going on for some months," she said.

Helen Weiss, who has been working at the Native Health Society
Medical Centre for six years, said yesterday five or six pharmacies
in Vancouver's Downtown Eastside have posed problems for years.

Methadone is prescribed to addicts as a substitute for heroin. To
ensure that the addicts consume the drug and do not resell it on the
street, the pharmacists are expected to watch the addicts as they
drink the methadone.

Dr. Weiss said she has heard from patients about pharmacies that
allow addicts to walk out with the methadone without drinking it. She
has heard of addicts drinking only a portion of the prescribed dose
and carrying the rest out of the pharmacy under their jacket to resell.

She has also been told of places that pay addicts $10 as an incentive
to bring their prescriptions to be filled daily at their outlet.

The pharmacies receive $8.60 from PharmaCare to dispense a drug and
an additional $7.70 for supervising a customer as they drink methadone.

Dr. Weiss said she first heard about the apparent kickback scheme
from a "street-working young woman" who had a flare-up with a man she
called her husband over a methadone prescription that was to be taken
to a pharmacy that did not offer cash. Her partner wanted the woman
to return to the clinic to have it changed.

"People talk and say, 'I got $10.' Then others say, 'I want $10. Why
shouldn't I get it?' " she said.

Dr. Weiss said she raised the issue of cash incentives with the
College of Pharmacists in January, after discussions with others at
the clinic who had similar concerns.

In an internal memo distributed to medical staff, Dr. Weiss said the
clinic was having increasing problems with patients aggressively
seeking to have all their medications dispensed daily. One of her
unstable HIV patients had been aggressively bullied by her partner to
change to his pharmacy once she left the office, Dr. Weiss told her colleagues.

"Another woman was also bullied by her partner outside when she
didn't succeed in getting [daily dispensed medication] from me," she
said, adding that the clinic needs a policy on the issue.

In another memo, she reported back to the clinic medical staff after
speaking to PharmaCare about "unethical practices of local
pharmacies." PharmaCare has received "numerous complaints," Dr. Weiss
said. However, she was told that PharmaCare had been unsure how to
proceed. Authorities had difficulty confronting the pharmacies
without firm evidence from credible witnesses.

"He assured me that action has now been initiated. He could not be
specific but states that we should be seeing results within the
month," she wrote in a memo last winter. "There will be a review on
licensing and payments surrounding methadone dispensing," she told
her colleagues.

Despite the assurances last winter, she was not aware of any action
taken by the authorities, Dr. Weiss said yesterday.