CORONER BACKS DRUG DESPITE FATALITIES

Methadone Called Valuable For Some

Jury Probes Deaths Tied To Medication

Methadone, designed to save lives by weaning addicts off cocaine and
other street drugs, has been linked to 258 deaths in Ontario over the
past four years, the province's deputy chief coroner has told an inquest.

That's an increase of 64 per cent over the 157 methadone-related
deaths reported in the previous period, 1996 to 1999.

Testimony resumes today at the three-week inquest, which was called in
the wake of a series of methadone-related deaths in Oshawa. The
inquest is expected to conclude this week with recommendations on how
to continue the drug-treatment programs while reducing fatalities.

On Friday, deputy coroner Jim Cairns said there had been a significant
"spike" in methadone deaths in the past four years after a drop at the
end of the 1990s. But when asked if the province's methadone program
should continue, Cairns said: "Absolutely."

"It is extremely valuable for certain individuals, and over-all, it is
in Canada's best interests to have a methadone program," Cairns testified.

Methadone is a synthetic drug that can stem cravings for heroin and
similar drugs. Addicts placed on methadone programs are usually
prescribed a single oral dose per day. Research shows that placing
heroin addicts on methadone replacement can improve their health, as
well as making them less likely to steal to finance an illicit habit,
or put themselves at risk by injecting heroin.

The OHIP-funded methadone treatment program, administered by specially
qualified physicians, is designed to save lives, the inquest has been
told. The inquest was called after the relatives of four Oshawa-area
families died after obtaining methadone, dispensed by an Oshawa
methadone clinic, the First Step Medical Clinic.

The five members of the coroner's jury heard Friday that, during the
most recent four-year survey, 16 other Oshawa-area people also died
with large quantities of methadone in their bodies.

Methadone-related deaths were also reported in dozens of other Ontario
centres over the past four years: 84 in Toronto, 34 in Hamilton, 16 in
Barrie and dozens elsewhere, jurors were told.

Cairns testified that the province is looking at the methadone program
"to see if there is any significant connection in these deaths, and to
try to put a finger on the pulse to see what is going on in the
province over-all.

"The methadone program is good, but if we can improve it, let's
improve it," Cairns told the inquest as it ended its third week of
hearings, which centre on the distribution of methadone by First Step
- -- one of the province's largest methadone clinics.

He said methadone offers a tremendous "health and social benefit,"
lowering the death rate from illegal drugs, reducing illnesses often
related to intravenous-drug use such as HIV/AIDS and hepatitis B and C
and cutting street crime.

In Oshawa, three of the methadone deaths were patients of First Step,
a downtown treatment centre. The fourth was a 17-year-old Bowmanville
Grade 12 student who obtained methadone from a friend's father who was
a patient at the clinic.

The inquest has been told that the three clinic patients also had a
variety of other drugs in their blood or in their possession at the
time of death. Methadone was the only lethal drug found in the
17-year-old.

Cairns said the job of identifying the role methadone played in many
of the deaths is more difficult because of a lack of co-operation from
the Ontario College of Physicians and Surgeons, the governing body for
Ontario doctors, which has invoked confidentiality provisions in the
Health Professions Act in refusing to release information to the
coroner's office.

Dr. Douglas Gourlay, recognized by the inquest as an expert in
methadone treatment, testified earlier that "countless lives" are
saved through methadone therapy.

He stressed that most of those who die with methadone in their bodies
have other drugs present as well.

In an interview Friday, Gourlay said statistics on lives saved through
methadone are skimpy. But a Swedish study in the late 1990s found the
mortality rate of street heroin addicts to be 63 times greater than
that of the regular population.

Patients discharged from that country's methadone program had a
mortality rate only four times the normal rate, he said.

While methadone is the treatment of choice now in Canada he said the
federal health department is expected to approve another, less potent
opiate replacement -- buprenorphine -- in the near future.

It is widely used in Europe and to a lesser extent in the United
States. Gourlay is using it on a trial basis in his practice at the
Centre for Addiction and Mental Health.