DRUG CLINIC RESULTS EXCEPTIONAL

Health: Retention rate in project is double Vancouver's

SAINT JOHN - The uptown methadone clinic is leading the country in
its retention rates, and could serve to be a model across the globe,
says a researcher with the Horizon Health Network.

Operating out of the St. Joseph's Community Health Centre, it is one
of two methadone clinics in the city, and in its first year of
operation 95 per cent of participants stayed. That is more than
double the rate in Vancouver's program, said Tim Christie, director
of ethics for Horizon.

The program - which also saw reduced crime and cocaine use - is
"absolutely" among the top methadone services in Canada, he said.

"The results speak for themselves."

Christie revealed the results of his study at the International Drug
Policy Reform Conference in Los Angeles earlier this month. He was
one of two Canadian researchers invited to the conference, which was
also attended by academics from Ukraine, Australia, and the U.K.

"People are astounded," he said, and other health services are
interested in introducing a similar model.

The program in uptown Saint John is different because there are no
barriers to accessing treatment - such as psychological assessments -
and someone can't be kicked out. There is also no mandatory
counselling component, which is a requirement for the methadone
program at Ridgewood Addiction Services. In 2009, 179 patients were
enrolled at the St. Joseph's clinic.

Christie's research also evaluated three other key indicators of
success: illicit drug use, crime and costs.

Urine tests from the first six months and last three months of the
program show there was a 66 per cent increase in the number of
methadone patients who stopped using illicit opiates, such as
OxyContin and Dilaudid, and there was a 13 per cent increase in the
number of who stoped cocaine, according to the tests.

The cocaine link was particularly telling because methadone has no
biological effects on cocaine use.

Christie said the results suggest methadone stabilizes people's
lives, so they aren't as likely to abuse other drugs.

"When people don't have to engage in that drug-seeking behaviour,
they use their time very constructively," he said.

Crime was reduced by 62 per cent among the patients who used the
clinic in its first year. Christie suggested the crime patients were
involved in may have been outstanding from before they enrolled in the program.

"The type of crimes are nowhere near as concerning as when people
were untreated, and the level of desperation is nowhere near the
same," he said.

Saint John Police Chief Bill Reid has said the methadone clinic has
helped reduce robberies in the city by half, for example.

Finally, Christie found that the costs of treatment were far less
than the cost of allowing an addict to go untreated.

From 2009 to 2010, the province spent a little more than $1 million
to treat 173 people.

But Christie said when you consider the health care, social and
criminal costs of an untreated addict, it adds up to $49,000 a year
per person. So the total cost of leaving those 173 people untreated
would be roughly $8.5 million.

"If you keep people in treatment, they don't have to do all these
things to buy illicit drugs," he said.

The cost of running the uptown program has decreased since 2009,
because the province has lowered pharmacist dispensing fees.

The fees still make up the majority of the cost of each dose.

Christie said more research is needed to pinpoint why the program's
retention rates - considered the most important measurement - are so
successful.

But he said the treatment philosophy of the clinic is really
beneficial, the staff are accepting of people's treatment plans, and
there is no involuntary discharge policy. The clinic also offers
primary care, is centrally located and connects patients to other
health services.

Julie Dingwell, a long-time proponent of the program and the
executive director of AIDS Saint John, called the research "brilliant."

"It says that it was important to get this (program) in place. The
need was great. The need is greater than what we're able to provide,
actually," she said. The waiting list for methadone treatment at the
clinic is consistently more than 300.

"I would think you've just got to look at the reduction in crime to
know that people's lives are changing drastically," she said.

Methadone is a maintenance treatment provided to stabilize the lives
of people addicted to opiate drugs, including prescription pills and heroin.

The uptown clinic provides people with a prescription which they fill
at participating pharmacies.

Christie's research paper has been submitted to the Canadian Medical
Association Journal for peer review.