INTERIM MOH POLICY ALLOWS NURSES TO GIVE METHADONE

An interim Ministry of Health policy now permits nurses at the
Sault's Addictions Treatment Centre to administer methadone.

Worried patients, concerned during the past few weeks about their
ongoing methadone treatments, have compelled governing bodies to
change the rules.

Methadone is a synthetic drug used in addiction treatment programs to
help stabilize the lives of people previously addicted to heroin, and
other opioid drugs including narcotic prescription pain relievers
such as OxyContin.

A March 15 notice posted on the Ontario College of Pharmacists' web
site announced that "the interim policy was developed in
collaboration with the College of Physicians and Surgeons of Ontario
and in consultation with Health Canada with the view to permit a
methadone maintenance treatment (MMT) model in Ontario that meets the
needs of patients..."

Under this new policy, according to the OCP, pharmacists can transfer
custody of the drug to a physician or their delegate (qualified
person) provided that physician has applied for and been granted a
new exemption by the College of Physicians and Surgeons of Ontario.

In 1996, the College of Physicians and Surgeons of Ontario (CPSO)
began to administer the provincial methadone program on behalf of the
Ministry of Health and Long-Term Care in cooperation with the Centre
for Addiction and Mental Health and the Ontario College of Pharmacists.

As such, pharmacists are accountable under the Drug and Pharmacies
Regulations Act and to the Ontario College of Pharmacists while
physicians are accountable to the College of Physicians and Surgeons
of Ontario.

The two colleges will collaborate on the development of a joint
policy to ensure adequate accountability within this non-traditional
approach to the provision of methadone while engaging in a process to
review the interim policy.

As well, the two colleges will be issuing, to pharmacists and
physicians involved in the provision of methadone, a document
outlining Fundamental Assumptions relating to methadone provision
which sets out the expectations of both Colleges for this area of practice.

Deanna Williams, registrar for the OCP, said the interim policy
assures patients who require methadone maintenance programs access to
the treatments they need and that pharmacists have more options in
providing care to patients.

The interim policy is considered a win by Ontario Addictions
Treatment Centre co-founder Dr. Jeff Daiter. In a STW interview last
month, Daiter insisted that his Queen Street methadone clinic in the
Sault -- along with 31 others in the province -- is a more
appropriate venue than a public pharmacy to treat patients. He called
it "an absolute insult to the nursing profession" that they were not
recognized by existing OCP policy as qualified to dispense methadone.

Daiter said nurses have been dispensing methadone in the Sault clinic
all along, under the direction of Dr. Chris Bruni and Dr. Lino Pistor.

Daiter's clinics have been under some fire recently for their
apparent connection with Wing and Susan Wong -- a Kitchener based
pharmacist couple -- who, according to some reports, had exclusive
rights to supply methadone and other drugs to the OATCs in exchange
for financial investments in the clinics.

The Ontario College of Pharmacists had imposed a March 13 deadline to
"shut down" the so-called "methadone pipeline" from sanctioned Wong
pharmacy whose nine-point discipline referral begins with "failure to
maintain a standard of practice". Earlier reports in the Toronto Star
described the Wong pharmacy as a "factory" from which boxes of
methadone were shipped regularly to OATC clinics across the province.

On March 16, 2006, though, the Ontario College of Pharmacists
rescinded the sanctions against Wong, given his "undertaking" to
comply with all terms and conditions of the interim policy.

OCP registrar Deanna Williams said she could not comment on the
Wongs' case as it was still under investigation, but she did confirm
that the Ontario College of Pharmacists had been approached -- and
has agreed -- to sit on a Government of Ontario task force to
investigate the Province's methadone dispensing system.

Ministry of Health and Long-term Care spokesperson John Letherby,
though, would not verify that such plans were in the works, saying it
was "premature to give a go-ahead or a blessing to the possibility of
a task force yet."

Letherby insisted that all options were being considered to ensure
that the "best practices for the safe delivery and safe supply" of
methadone were being provided to the patients who depend on it for
their maintenance programs. He could not say what, if any, options
other than a possible task force were being considered by the
Ministry to address how best to ensure methadone treatment programs
are monitored.

Meanwhile, according to the Toronto Star, OATC lawyers are awaiting
word from the courts.

Monday they sought to have a Newmarket hearing date set to "quash"
three OPP warrants issued last November investigating the clinics.