News (Media Awareness Project) - CN NF: Part 1: The Problem, Why Do We Need A Methadone Program |
| Title: | CN NF: Part 1: The Problem, Why Do We Need A Methadone Program |
| Published On: | 2009-10-23 |
| Source: | Telegram, The (CN NF) |
| Fetched On: | 2009-10-25 14:58:41 |
PART 1: THE PROBLEM
Why Do We Need A Methadone Program Anyway?
First in a three-part series examining the effectiveness of the
province's methadone treatment program for drug addictions
The first time J.J. tried to detox, he thought he was going to
die.
"The sickness is probably comparable to somebody's last few days of
cancer," he says, describing constant diarrhea, vomiting, muscle
aches, joint pains and cravings.
As he came off heroin in the Vancouver Harbour Light, J.J. didn't
know he'd start using again.
And again.
People don't die from coming off opiates like heroin, OxyContin and
morphine, but most addicts will tell you that they want to.
The success rate of detoxification is low, but in the past few years
there's been another option for addicts in this province - methadone.
But even methadone advocates will say it doesn't work for everyone
and it can have serious side effects.
Used properly, it can help some people change their
lives.
This time around, J.J. is using methadone.
"It's not the magic cure. There's a whole lot of other shit (you've)
got to deal with. And I'm one of the lucky ones," he says, looking
down at his two-year-old son playing with colouring books on the
floor of the St. John's apartment, where the boy lives with his mother.
After getting clean and clear of the heroin he'd gotten hooked on in
jail in British Columbia, J.J. came back to his home province to
attend college in Labrador.
When his father died, and he and his girlfriend broke up, he got back
on the drugs. This time it was OxyContin.
He went to a doctor while he was in St. John's for his father's
funeral and said he was trying to get weaned off the drugs.
At the height of the OxyContin crisis, J.J. was prescribed seven
tablets of OxyContin a day.
His sister did the same and was prescribed 12 tablets a day, J.J.
says.
The high from OxyContin is exactly the same as from heroin, he
says.
But once he started methadone, even when J.J. tried to get high, he
felt nothing.
"It blocks the buzz completely."
Now J.J. has started weaning off the methadone, a milligram a week.
He has 39 mg to go.
He cares for his son regularly and is looking for work for the first
time in years.
"It's a nuisance to me now, but I don't want to rush getting off it,"
he says.
"Once I get off methadone I know I can get a buzz off Oxy again. ...
You do Oxy two, three days in a row and you'll be hooked."
For years, the addictions treatment program in St. John's had treated
people for alcohol, marijuana and cocaine additions.
Then the first OxyContin junkies walked through the
doors.
Barry Hewitt, the head of addictions services, says things changed in
the capital city when OxyContin appeared here earlier this decade.
Treatment at the recovery centre changes shortly after.
The addicts came from everywhere, Hewitt recalls.
Some of them had legitimate pain and were prescribed OxyContin and
became dependent on it. Others were buying it on the street.
By the time the OxyContin task force sent out its final report in
2004, Hewitt and others working at the Pleasantville recovery centre
had gone from seeing the odd narcotics addict to more than 100 within
two years.
That number didn't include addicts still on the street who weren't
looking for help.
"One person actually brought in a picture of himself and said, 'This
is who I want to be again.'" Hewitt says.
Prostitution, thefts and armed robberies were on the
rise.
Residential and commercial break and enters were up roughly 30 per
cent in 2004 over 2003, and armed robberies doubled.
Then, in 2005, an explosive story broke about a St. John's physician,
Dr. Sean Buckingham, who had been prescribing drugs in exchange for
sex.
Suddenly, "OxyCodone," "needle exchange," and "detox" became
household words in what had been thought to be a relatively
crime-free, drug-free city.
Five of the 50 recommendations of the OxyContin task force were
related to using methadone to treat OxyContin addiction.
Today, methadone is prescribed and distributed by a handful of
doctors and pharmacists specially trained in the use of the drug for
about 600 addicts across the province.
There is no average addict, Hewitt says, but many of the people he
sees are young men who have been using for five or six years.
The waitlist at the treatment centre has more than 60 names on it,
and there are waitlists at doctors' offices as well.
Methadone, a synthetic opiate, was created to battle heroin addiction
in veterans of the Second World War, who became addicted when heroin
was used as a pain-management alternative to morphine.
The breakthrough with methadone was that it gave relief to those
going through the sickness of withdrawal and also blocked receptors
for opiates, meaning that users couldn't get high from other opiates
when they were taking the drug.
Users can, however, still get high from some drugs, like cocaine and
marijuana.
Experts say another benefit of methadone is that a person isn't
impaired when taking it. That's why it's regularly prescribed to
people who are suffering from chronic pain.
Advocates for the use of methadone say it's a proven way for addicts
to "get their heads straight," and stabilize their lives.
Then the weaning process begins.
"We don't tell a person how long they should be on methadone. A
person decides for themselves how long they want to be on (it),"
Hewitt says.
"It's only when they get down to the lower doses ... that's when the
scary part kicks in. That's when some of the triggers happen and the
anxiety comes up. That's when you need the most resources."
Hewitt says frankly, as long as people are seeing the benefits of
methadone, he doesn't care if they stay on it for life, though that
doesn't happen often.
And no wonder. People don't want to have to visit a pharmacy every
day of their lives. They want to be able to travel or move without
the hassle of having to have prescriptions transferred and finding
new doctors and pharmacists and building relationships with them.
"It's not an option for everyone because you've got to be committed
and it regulates your life," Hewitt says of methadone treatment,
adding that it's difficult to maintain it in rural areas.
In some parts of the province there are no doctors prescribing
methadone, while in other parts there are no pharmacies selling it,
meaning some people have to travel for one or the other.
The success rate of methadone treatment is boosted greatly when
counselling is a part of the program.
It was a particular problem with the program - a lack of doctors and
pharmacies treating addicts in St. John's - that got Dr. Jeff White
involved.
White was looking for a new focus for his career when he read a story
in The Telegram about a couple who'd had their child removed from
their care because of their addictions. The couple said they wanted
to get off OxyContin and they had to move to central Newfoundland
for methadone treatment.
White knew no one in St. John's was prescribing the drug and decided
to get training through Health Canada.
"I thought this might be an interesting sideline at the time, but it
certainly blossomed into a busier practice than I'd expected," White
says.
About 70 per cent of his patients - 300 people - are on
methadone.
He'd like to see more doctors and pharmacists taking part in the
program.
"I think what deters the other doctors is the clientele. ... The
training is not difficult, it's not long."
People are in need of help, he says.
And though OxyContin is still on the street, White says he hears
regularly that methadone's out there too.
Most of the addicts who come to him now say they've tried methadone
before.
It's actually cheaper than OxyContin on the street, White
says.
And though the methadone program in this province is one of the
strongest compared to others in North America and the U.K., some
things are still lacking.
FAST FACTS
All about Methadone
Methadone was developed in Germany as a substitute for
morphine.
In the 1960s, researchers in the United States used methadone to help
some veterans kick the heroin habit they developed in lieu of taking
morphine during the Second World War.
Further research by Canadian doctors helped create the first
methadone maintenance treatment program in British Columbia in 1963.
Methadone is one of two drugs regularly prescribed to deal with
addicts' cravings.
National guidelines for prescribing methadone were introduced in
1972.
Source: Health Canada
METHADONE BY THE NUMBERS
$7-$10 the cost of a single dose of methadone.
$50 the cost of a single 80-milligram tablet of OxyContin on the
street.
46 Number of community pharmacies in the province permitted to
distribute methadone, not including the methadone program or hospital
pharmacies.
60-100 number of milligrams of methadone addicts tend to start
on.
124 the number of people in the methadone treatment
program.
64 the number of people waiting to get into the program.
592 the number of people in the province prescribed methadone as of
Oct. 15.
550 the number of estimated injection drug users in this province in
2007.
6,000 the number of clean needles provided through the
needle-exchange program through the AIDS Committee of NL in 2006.
$625,000 the annual budget of the methadone treatment program, which
goes to salaries, medical supplies, office supplies and groceries
(fruit and coffee for staff and addicts).
Saturday: Part 2: The controversy.
Is methadone good medicine or just another opiate for addicts?
Why Do We Need A Methadone Program Anyway?
First in a three-part series examining the effectiveness of the
province's methadone treatment program for drug addictions
The first time J.J. tried to detox, he thought he was going to
die.
"The sickness is probably comparable to somebody's last few days of
cancer," he says, describing constant diarrhea, vomiting, muscle
aches, joint pains and cravings.
As he came off heroin in the Vancouver Harbour Light, J.J. didn't
know he'd start using again.
And again.
People don't die from coming off opiates like heroin, OxyContin and
morphine, but most addicts will tell you that they want to.
The success rate of detoxification is low, but in the past few years
there's been another option for addicts in this province - methadone.
But even methadone advocates will say it doesn't work for everyone
and it can have serious side effects.
Used properly, it can help some people change their
lives.
This time around, J.J. is using methadone.
"It's not the magic cure. There's a whole lot of other shit (you've)
got to deal with. And I'm one of the lucky ones," he says, looking
down at his two-year-old son playing with colouring books on the
floor of the St. John's apartment, where the boy lives with his mother.
After getting clean and clear of the heroin he'd gotten hooked on in
jail in British Columbia, J.J. came back to his home province to
attend college in Labrador.
When his father died, and he and his girlfriend broke up, he got back
on the drugs. This time it was OxyContin.
He went to a doctor while he was in St. John's for his father's
funeral and said he was trying to get weaned off the drugs.
At the height of the OxyContin crisis, J.J. was prescribed seven
tablets of OxyContin a day.
His sister did the same and was prescribed 12 tablets a day, J.J.
says.
The high from OxyContin is exactly the same as from heroin, he
says.
But once he started methadone, even when J.J. tried to get high, he
felt nothing.
"It blocks the buzz completely."
Now J.J. has started weaning off the methadone, a milligram a week.
He has 39 mg to go.
He cares for his son regularly and is looking for work for the first
time in years.
"It's a nuisance to me now, but I don't want to rush getting off it,"
he says.
"Once I get off methadone I know I can get a buzz off Oxy again. ...
You do Oxy two, three days in a row and you'll be hooked."
For years, the addictions treatment program in St. John's had treated
people for alcohol, marijuana and cocaine additions.
Then the first OxyContin junkies walked through the
doors.
Barry Hewitt, the head of addictions services, says things changed in
the capital city when OxyContin appeared here earlier this decade.
Treatment at the recovery centre changes shortly after.
The addicts came from everywhere, Hewitt recalls.
Some of them had legitimate pain and were prescribed OxyContin and
became dependent on it. Others were buying it on the street.
By the time the OxyContin task force sent out its final report in
2004, Hewitt and others working at the Pleasantville recovery centre
had gone from seeing the odd narcotics addict to more than 100 within
two years.
That number didn't include addicts still on the street who weren't
looking for help.
"One person actually brought in a picture of himself and said, 'This
is who I want to be again.'" Hewitt says.
Prostitution, thefts and armed robberies were on the
rise.
Residential and commercial break and enters were up roughly 30 per
cent in 2004 over 2003, and armed robberies doubled.
Then, in 2005, an explosive story broke about a St. John's physician,
Dr. Sean Buckingham, who had been prescribing drugs in exchange for
sex.
Suddenly, "OxyCodone," "needle exchange," and "detox" became
household words in what had been thought to be a relatively
crime-free, drug-free city.
Five of the 50 recommendations of the OxyContin task force were
related to using methadone to treat OxyContin addiction.
Today, methadone is prescribed and distributed by a handful of
doctors and pharmacists specially trained in the use of the drug for
about 600 addicts across the province.
There is no average addict, Hewitt says, but many of the people he
sees are young men who have been using for five or six years.
The waitlist at the treatment centre has more than 60 names on it,
and there are waitlists at doctors' offices as well.
Methadone, a synthetic opiate, was created to battle heroin addiction
in veterans of the Second World War, who became addicted when heroin
was used as a pain-management alternative to morphine.
The breakthrough with methadone was that it gave relief to those
going through the sickness of withdrawal and also blocked receptors
for opiates, meaning that users couldn't get high from other opiates
when they were taking the drug.
Users can, however, still get high from some drugs, like cocaine and
marijuana.
Experts say another benefit of methadone is that a person isn't
impaired when taking it. That's why it's regularly prescribed to
people who are suffering from chronic pain.
Advocates for the use of methadone say it's a proven way for addicts
to "get their heads straight," and stabilize their lives.
Then the weaning process begins.
"We don't tell a person how long they should be on methadone. A
person decides for themselves how long they want to be on (it),"
Hewitt says.
"It's only when they get down to the lower doses ... that's when the
scary part kicks in. That's when some of the triggers happen and the
anxiety comes up. That's when you need the most resources."
Hewitt says frankly, as long as people are seeing the benefits of
methadone, he doesn't care if they stay on it for life, though that
doesn't happen often.
And no wonder. People don't want to have to visit a pharmacy every
day of their lives. They want to be able to travel or move without
the hassle of having to have prescriptions transferred and finding
new doctors and pharmacists and building relationships with them.
"It's not an option for everyone because you've got to be committed
and it regulates your life," Hewitt says of methadone treatment,
adding that it's difficult to maintain it in rural areas.
In some parts of the province there are no doctors prescribing
methadone, while in other parts there are no pharmacies selling it,
meaning some people have to travel for one or the other.
The success rate of methadone treatment is boosted greatly when
counselling is a part of the program.
It was a particular problem with the program - a lack of doctors and
pharmacies treating addicts in St. John's - that got Dr. Jeff White
involved.
White was looking for a new focus for his career when he read a story
in The Telegram about a couple who'd had their child removed from
their care because of their addictions. The couple said they wanted
to get off OxyContin and they had to move to central Newfoundland
for methadone treatment.
White knew no one in St. John's was prescribing the drug and decided
to get training through Health Canada.
"I thought this might be an interesting sideline at the time, but it
certainly blossomed into a busier practice than I'd expected," White
says.
About 70 per cent of his patients - 300 people - are on
methadone.
He'd like to see more doctors and pharmacists taking part in the
program.
"I think what deters the other doctors is the clientele. ... The
training is not difficult, it's not long."
People are in need of help, he says.
And though OxyContin is still on the street, White says he hears
regularly that methadone's out there too.
Most of the addicts who come to him now say they've tried methadone
before.
It's actually cheaper than OxyContin on the street, White
says.
And though the methadone program in this province is one of the
strongest compared to others in North America and the U.K., some
things are still lacking.
FAST FACTS
All about Methadone
Methadone was developed in Germany as a substitute for
morphine.
In the 1960s, researchers in the United States used methadone to help
some veterans kick the heroin habit they developed in lieu of taking
morphine during the Second World War.
Further research by Canadian doctors helped create the first
methadone maintenance treatment program in British Columbia in 1963.
Methadone is one of two drugs regularly prescribed to deal with
addicts' cravings.
National guidelines for prescribing methadone were introduced in
1972.
Source: Health Canada
METHADONE BY THE NUMBERS
$7-$10 the cost of a single dose of methadone.
$50 the cost of a single 80-milligram tablet of OxyContin on the
street.
46 Number of community pharmacies in the province permitted to
distribute methadone, not including the methadone program or hospital
pharmacies.
60-100 number of milligrams of methadone addicts tend to start
on.
124 the number of people in the methadone treatment
program.
64 the number of people waiting to get into the program.
592 the number of people in the province prescribed methadone as of
Oct. 15.
550 the number of estimated injection drug users in this province in
2007.
6,000 the number of clean needles provided through the
needle-exchange program through the AIDS Committee of NL in 2006.
$625,000 the annual budget of the methadone treatment program, which
goes to salaries, medical supplies, office supplies and groceries
(fruit and coffee for staff and addicts).
Saturday: Part 2: The controversy.
Is methadone good medicine or just another opiate for addicts?
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