PROVINCE TO PROBE METHADONE MISUSE

Task Force Formed After Star Stories

Problems With Drug Distribution Found

The Ontario government is launching a task force to fix serious
problems in the province's methadone dispensing system.

The task force, launched following an ongoing Toronto Star
investigation, will include senior representatives from the Ontario
Health Insurance Plan, the provincial coroner's office, and the
colleges that regulate doctors, pharmacists and nurses. It will
report directly to Ontario Health Minister George Smitherman. The
task force will be told to quickly come up with clear-cut policies on
how the potentially dangerous narcotic should be safely administered
to patients and how it should be regulated. It will also probe
whether the methadone for addicts program is being used as a profit
centre for some doctors, rather than for the benefit of vulnerable patients.

Methadone is a federally sanctioned, synthetic narcotic used by
addicts who are trying to wean themselves off heroin and opiate-based
painkillers.

Recently, the Star reported that a group of clinics that treat one
third of Ontario's 14,000 methadone patients are billing OHIP 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 the clinics. 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.

The doctors are part of the Ontario Addiction Treatment Centres
(OATC), a chain of 24 clinics that is owned by Drs. Jeff Daiter and
Michael Varenbut, both of Richmond Hill. The pharmacist is Wing Wong
of Kitchener.

All three have denied any wrongdoing, either in brief interviews with
the Star or through their lawyers.

Meanwhile, the Ontario Provincial Police are investigating the
doctors' schemes and the provincial coroner's office is looking into
two deaths related to the clinics.

An inquest may be called into at least one of those deaths.

Chief Coroner Barry McLellan and others have confirmed they will be
on the task force, which is expected to make recommendations within
three months.

"It will be an adviser to the minister on a number of quality issues
around methadone programs," McLellan said. His office is probing two
deaths at the Ontario Addiction Treatment Centres and an inquest may
be called into one or both of the deaths. One person died from a
risky procedure called rapid opiate detoxification. Another died when
clinic staff mixed up his methadone dose and gave him 10 times what
his body could handle.

Rocco Gerace, registrar of the Ontario College of Physicians of
Surgeons, will also sit on the task force, as will the registrar of
the College of Pharmacists, Deanna Williams. A spokesman for the
Ontario College of Nurses was unable to confirm that college's
involvement, but nurses are an important part of the methadone system
since they typically hand out the doses in clinics like those run by
OATC. Health Canada, which also has a role in methadone control, will
likely have input. Other key members will be supplied by OHIP, the
provincial health insurance plan that pays for most of the treatment.

In its investigation, the Star found that the methadone program has
been allowed to grow virtually unchecked since the federal government
downloaded responsibility to the provinces in 1996.

Back then, only about 300 people in Ontario took the drug. Today,
14,000 addicts take the daily drink and the various medical colleges
that are supposed to tightly regulate it instead turned a blind eye
to controversial and potentially dangerous practices.

A confusing array of rules attempt to govern methadone, and they
frequently change. For example, the college of pharmacists recently
laid a series of disciplinary allegations against pharmacist Wing
Wong in Kitchener. The college alleged that he was not properly
dispensing the methadone since he was sending thousands of
prescription bottles by courier to the OATC clinics across Ontario to
be handed out by nurses. Wong was being paid by the Ontario Drug
Benefit Plan as if he was personally dispensing methadone and other
drugs, when he was simply shipping them out the door. Other
allegations against Wong relate to overcharging dispensing fees,
sloppy record-keeping and prescription labelling, and the manner in
which he obtained a monopoly on OATC patients.

Wong was told to stop shipping methadone by March 13.

Just a few days after that deadline (following numerous calls by
concerned OATC patients to the College of Pharmacists), a new
"interim" policy emerged that effectively allows Wong to keep
shipping provided OATC doctors get a special federal exemption
permitting them to delegate the dispensing of methadone to a
"qualified person" such as a nurse.

The College of Pharmacists says it still plans to proceed with the
disciplinary action against Wong and his wife, also a pharmacist.

The task force will delve deeply into the business of methadone. The
Star found that OATC doctors had discovered they could bill OHIP for
a myriad of tests that were often not used for patient care. While
OATC founders claim they are key to the well-being of patients,
numerous experts and the College of Physicians and Surgeons disagree.
Still, the testing and high payments continue.

The Star has learned that OATC is running thousands of tests weekly
in its Woodbridge clinic. The technician who performs the test is not
a provincially qualified lab technician and the lab machines are not
subject to quality control rules that govern proper labs in Ontario.

Ministry of Health officials won't discuss the case.

Another issue for the task force will be whether a doctor should be
allowed to bill OHIP for treatment (testing urine) of patients they never see.

Many of these issues are being explored by the OPP, which executed
three search warrants on OATC clinics last November.

The Star has tried to obtain these warrants but OATC lawyers are
opposing the Star in court, stating that revealing the contents of
the warrants would tarnish their client's reputation. No charges have
been laid.

Today, at a court hearing in Newmarket, lawyers for the OATC will
seek a hearing date to have the warrants "quashed," which would
effectively end the criminal investigation.

The OPP and the Crown attorney for Newmarket are opposing the application.