HEROIN ADDICTS HIT THE ROAD TO KICK IT

Addicts Likely to Relapse, Says Head of Addictions Program, Because
They Have to Take a Bus -- or Worse Hitchhike -- to Get Access to Methadone.

Heroin addicts in Maple Ridge and Pitt Meadows who want to get clean
and onto a methadone program usually travel to Mission, New
Westminster or Vancouver to get their prescription, putting them at
serious risk of relapsing, because there are no local "methadone
maintenance" clinics.

Ron Lawrence, executive director of Alouette Addictions in Maple
Ridge, estimated his centre has about 45 to 50 clients who need to
commute to clinics outside Maple Ridge and Pitt Meadows to pick up
their methadone prescription.

Commuting, though, might mean hitchhiking, taking the bus, SkyTrain or
West Coast Express, and all these increase the risk of going back to
heroin use.

"Most SkyTrain stations have drug dealers," said Dimitry Noel-Bentley,
clinical supervisor at Alouette Addictions.

In addition to coming in contact with dealers, public transportation
can be unreliable and can compromise the patient-doctor trust, which
is crucial for methadone maintenance, Lawrence said.

When an addict misses an appointment for his or her methadone
prescription, the doctor doesn't know what the reason is.

"They're late getting in. Then they don't get their methadone dose and
they start getting sick; then they turn back to heroin," Lawrence
said. "The doctor has no way of knowing how well they're doing."

When addicts are first put on methadone, they often need to see their
doctor several times a week to see how the dose is working and for the
doctor to monitor that they aren't back on heroin. This means they're
going back and forth between home and the clinic.

Lawrence said it's also important for counsellors and doctors to be in
contact with each other about the addict's treatment.

"The counselling really needs to be attached to (the medical
treatment) in order of it to be a successful program," said Lawrence.
"If they're attached to the same place, then they'd get the
counselling and the methadone or whatever other medication they need.
When they're working in the same agency...they can fairly easily share
information back and forth."

After an extensive survey of agencies and the community at large, the
Maple Ridge-Pitt Meadows Substance Misuse Prevention Task Force gave
33 recommendations last spring, and one was to provide "local access
to methadone maintenance."

The Fraser Health Authority's mental health and addictions department
is also working to identify "gaps in methadone service," according to
Andy Libbiter, director of the department.

"We're conducting an analysis right across Fraser Health now looking
at all communities to get data and trying to establish where the gaps
are," Libbiter said. After this "gap analysis," Libbiter said the
Fraser Health Authority will "formulate some kind of response."

"There are prescribing methadone doctors here in Maple Ridge, but
there is no centralized system," Lawrence said.

And finding them is no easy task.

The B.C. College of Physicians and Surgeons holds a one-day Methadone
101 course and follow-up sessions with doctors who want to prescribe
methadone, but they don't give out the names of those doctors.

If someone wants to find a doctor prescribing methadone, the College
sends them to regional clinic, which charge between $60 and $65
monthly for an assessment by a counsellor and a doctor, and follow-up
appointments with a counsellor.