METHADONE CLINIC OPEN IN NAPANEE

Napanee's first methadone clinic opened this week at 104 John Street
and has already begun seeing patients. The Napanee MMT (Methadone
Maintenance Treatment) Clinic will be open three half days a week,
and will see patients who would normally be seen in Kingston or Belleville.

The clinic will be run by Dr. Brian Hadley, a general practitioner,
who has worked at a similar clinic in Belleville part time for the
last couple years.

According to Stafford Murphy, executive director of Napanee
Addictions Services, the main benefit of having the clinic locate
here is a transportation issue. This is twofold.

Currently, people taking methadone must travel to their doctor's
appointments in either Kingston or Belleville. Over time, this may
become a barrier for some to getting other aspects of their life
stabilized. For instance if they're able to hold down a job, but have
to take time off for the required doctor's appointments.

The other side is that because there is a clinic nearby, more people
who might benefit from the treatment will have access to it.

Methadone is a legal drug prescribed to people with addictions to
opioids to help curb and ideally eventually cure their addiction. The
clinic itself does not store methadone, it is prescribed by
specially-trained physicians and then dispensed at a local pharmacy,
where patients are observed as they drink' their dose of the drug,
which is administered suspended in Tang, before they leave the store.

Wallaces is the only drugstore in Napanee that dispenses methadone,
as pharmacies require a special exemption to be able to dispense it.

Methadone is dissolved in juice so that people can't inject it, since
it would be fatal. It also leads to a slower release and longer
lasting effect of the drug since it enters through the stomach
instead of directly into eh bloodstream.

Clinic director and on-site physician Hadley said he fell into the
Napanee clinic by accident. He did some research and saw there was a need.

"It's a good alternative to practicing family medicine and it's very
rewarding. The rewards are amazing.

He said he sees patients go from desperation to getting their lives
back with the stabilizing effects of the drug.

Methadone specifically treats opioid addiction, such as Percocet, a
drug prescribed by doctors for painkillers.

Hadley said a $50 prescription might sell for $10 - $20 per pill on
the street, making the illegal prescription drug trade a very
lucrative criminal business.

"Almost everything you can buy on the street is diverted from
doctor's prescriptions," said Hadley. He said addicts have many
methods of getting legitimate prescriptions written.

"A lot of people have pain. A lot of people have psychic pain. It's a
different problem," he said.

The opiates are painkillers and Hadley said they give a sense of euphoria.

"If you're addicted, they satisfy a craving."

After painkillers, the next step up' is morphine and its derivatives.

"Heroin used to be number one. You don't see heroin in Ontario any more."

Hadley said it was a "bright spark" who invented methadone in the 1940s.

Methadone works by blocking the receptors and therefore cravings for opiates.

"Ten per cent of all people you give a narcotic to have the potential
to be addicted from daily use for a short period of time," he said.

A narcotic will leave the system quickly, especially if it's been
injected directly into a vein, which brings risks of overdose and
spread of blood-borne diseases with shared needle use.

Methadone is long-lasting, and gives a slow release effect as it is
taken as a drink.

"If you're on the proper dose of methadone and you do use a street
drug, it blocks the effect, so what's the point of taking the street
drug?" Hadley added.

Patients seeking help for narcotic addiction can self-refer, or may
be referred by a doctor. OHIP covers the service, although patients
pay for their own prescription, which costs $ per day. This cost is
legislated to be low, so the treatment is affordable.

Hadley said methadone is lethal, with a low toxic/therapeutic range,
and that's why so much attention is given to patients.

"The vast majority of people walking in the door want help," he said.

At their first appointment, they are given a 30-minute questionnaire,
and then a trained nurse goes over it with them.

Every doctor's visit, up to three times per week in the early
treatment stages, includes a urinalysis. This tests for other drugs.

Patients are either personally chaperoned, or in the case of the
Napanee clinic, observed on closed circuit television, to be sure the
urine specimen dipped matches the person.

The point of methadone is to bring stability first, and then to help
the person eventually kick their narcotic habit.

"One of the rewards of stability is take-home carries," Hadley explained.

After a minimum of eight weeks, instead of drinking their drink at
the pharmacy, they are eligible to come only six days per week, and
take one day home.

There is careful screening to make sure it is safe, but as the months
and years pass, patients on methadone might pick up as much as one
week at a time. They still require weekly urinalysis appointments.

Hadley said that in a motivated individual, the success rate for
kicking the narcotics addiction is very high.

"The stuff really works. The benefits to society you can provide with
methadone is amazing."

For instance, Hadley said an addict is arrested an average of two to
three times per year, but only 2 to 3 per cent of methadone patients
get into trouble with the law.

Murphy said sometimes people have a philosophical problem with
methadone, that one addiction is being substituted for another.

"Ideally it would be great if nobody was addicted to anything at any
time, but that isn't realistic, so if somebody is at a point where
they don't want to use opiates, I certainly would rather they could
use methadone."

Stafford also notes there are two different kinds of addicts.

"You have people who are involved in the drug subculture, but you
also have individuals that never really had a problem with drugs or
alcohol but had some sort of legitimate medical problem and were
prescribed some sort of painkiller and from that initial prescription
ended up getting addicted."

He said coming off any narcotic, the physical symptoms are extreme,
and may last several days.

"Withdrawal is a real deterrent. Simply to quit using them, you're
going to be physically ill, so a lot of people will seek an alternative."

Stafford said the benefit to the community is that "having people on
methadone does improve the chances there will be less criminal
activity, less need for buying opiates off the street or resorting to
criminal activities so they can purchase the drugs," he said.

"Once it's more known in the community, I wouldn't be surprised if it
does increase the number of people who are on methadone."

There are few known side effects for methadone, and patients can be
on maintenance for years. You can drive and work while on methadone,
although some people experience drowsiness, and Hadley said they
would definitely be advised not to drive.

Murphy said he hopes to work closely with Hadley as the practice gets
established since counselling is an important part of any methadone program.

Currently there are a little less than 100 people in the Napanee area
on methadone, and any who are in need of financial assistance would
have their transportation to medical appointments in either
Belleville or Napanee covered, so there is a potential savings to the
county as well.

The clinic is open Monday, Wednesday, and Thursday mornings for
appointments. Call 354-9993 for more information.

Ron van Straalen, detachment commander for the Napanee OPP said he
hasn't heard of there being a specific problem in Napanee with
narcotics, but said any increase in local service is good for the community.