TASK FORCE TO PROBE METHADONE CARE

Provincial Investigation Follows Star Series

Addiction Control Program Found To Lack Oversight

A provincial task force will probe who gets the addiction drug
methadone and how much doctors and pharmacists are paid for treating
these patients.

Health Minister George Smitherman yesterday announced the task
force's terms of reference and named 20 people to the panel.

A recent Toronto Star investigation revealed serious problems in the
way the methadone program is administered. The provincial program,
designed to help wean people off heroin, has grown virtually
unchecked over the past 10 years.

Provincial authorities, the Star found, have almost no control over
who gets on the program, and no knowledge of whether their treatment
is effective.

From 300 mainly heroin addicts in 1996, the program has grown to
include 14,000 people who get daily doses of the sometimes helpful,
but highly addictive synthetic drug. Many were addicted to
opiate-based painkillers and have traded one addiction for another --
arguably a more serious addiction in cases where the patients were
initially addicted to the painkillers.

The Star series also raised serious questions over high payments from
the public purse for the program.

Ontario Addiction Treatment Centres, a group of clinics that treats
one-third of Ontario's 14,000 methadone patients, is billing the
Ontario Health Insurance Plan for expensive urine tests that are
rarely used for patient care and running the tests through an
unlicensed laboratory. Many of its doctors are being paid for
treating patients they never see, the Star found.

In addition, the clinics have a controversial relationship with a
Kitchener pharmacist who gets exclusive rights to supply methadone
and other drugs to them. In return, the pharmacist makes financial
investments in the clinics and purchases medical software sold by its
founders, both practices that are frowned upon by regulators.

Smitherman's task force will probe many of these issues. The
government wants to find a "fair payment model" for doctors and pharmacists.

The Star also examined the deaths of two patients treated by the
clinics. One died of an overdose after prescriptions were confused
and another was given an aggressive form of therapy called "rapid
detox." While the coroner's office is probing those deaths,
Smitherman noted that the task force will help the province ensure
that methadone treatment is "provided in a safe and effective way."

The task force will also examine the quality of methadone care
provided in Ontario and look to see if the province needs better
training and a stricter method for dealing with problems in the
program. The Star found that the physicians' and pharmacists'
colleges (which help regulate the program) were aware of problems for
several years but only began to take action when they learned of a
media investigation.

Task force chair Anton Hart said he looks forward to the discussions.
Disputes in communities where methadone clinics have attempted to set
up helped ignite his interest in the topic.

Hart is publisher of Longwoods Publishing, which produces medical journals.

Members of the task force include Ontario's chief coroner, the
registrars of Ontario's physicians' and pharmacists' colleges, and
senior representatives of nurses' associations and the nurses'
college, local health units, the provincial medical association and
two methadone patients.

Senior representatives of the provincial health ministry, the Centre
for Addiction and Mental Health, and Health Canada will also sit on
the task force.