INSIDE METHADONE CLINIC

Without methadone, he might be dead: addict

Fredericton doctor has assumed a responsibility most physicians aren't
willing to bear

Every Thursday a Cambridge-Narrows doctor and a Miramichi man make
parallel journeys to a methadone clinic in Fredericton.

As one of the few New Brunswick doctors licensed to prescribe
methadone to drug addicts, Dr. Dianne Stackhouse has been making the
trip to the Community Health Centre for the past 15 months. One of
those addicts hopes his weekly trek will lead him on the road to recovery.

Dr. Stackhouse has assumed a responsibility most physicians aren't
willing to bear. While she assesses each patient's need for methadone,
and adjusts his or her dosage accordingly, that's only part of her
overall involvement. There's also counselling for issues relating to
the overuse or misuse of narcotics.

This story, of a doctor and a patient, is a quiet testimonial to the
very real problem of drug abuse in the province, and what's being done
to curb it. Each day at the Fredericton centre, 48 people receive
methadone, but that's just a fraction of the number of people who need
it.

Dr. Stackhouse, who blames society's drug problem on the breakdown of
the family unit, says methadone is only a tool in the treatment of
narcotic addiction.

"It's a job," says Dr. Stackhouse, a family physician for nearly 29
years. "Just writing the prescription for the methadone is not the
whole picture. It's not the major part of the treatment."

Once people stop taking the painkillers, they're subject to
withdrawals, which can include bone aches, sweating, diarrhea,
vomiting and headaches.

"The body develops a dependency on a certain blood level it thinks it
needs," Dr. Stackhouse said. "And when that's not there, then there's
physical illness symptoms."

Methadone maintenance treatment provides a heroin addict with
individualized health care and medically-prescribed methadone to
relieve withdrawal symptoms, reduce the opiate craving, and bring
about a biochemical balance in the body. Important elements in the
treatment include comprehensive social and rehabilitation services.

The Miramichi man, who asked that his real name not be used, says the
methadone treatments have saved his life.

"Without that I'd have never come around," he said. "I'd either be
dead or still doing it, I guess."

While at the Fredericton clinic, he receives an assessment and
counselling. After getting his prescription from Dr. Stackhouse, he's
able to obtain his methadone from a pharmacy in Miramichi.

Seven days later, he's back on the road to Fredericton, and repeats
the process.

Curious to see what all the fuss was about, he started using drugs
recreationally and quickly fell into a trap. Dilaudid, which was
readily available on the street, became his vice. The synthetic heroin
is a powerful prescription painkiller.

After four or five years in a downward spiral, and fearing he might
lose his family, he checked into detox and took different programs.
But nothing worked.

"As soon as I got out, I'd go right back to the same way," said the
28-year-old married father of one. "It screwed up my whole life."

Because he had always worked, he had money and didn't need to get
involved in criminal activity to support his habit. He did ruin his
credit, however, racking up $30,000 in debt to fund his dope.

He started the methadone treatments just before Christmas, and within
a couple of weeks, he had sworn off Dilaudid. He says the methadone
has eliminated his cravings.

(Noel Chenier/Telegraph-Journal) One addict credits the methadone,
above, with saving his life. "It helped me tremendously," he said.
"That's the problem with the detox. You go in there and you feel so
bad. Once you get hooked on the pills, if you don't have them, you
can't navigate. You can't get out of bed in the morning if you don't
have a pill."

Though he's been clean for some time, he still sees plenty of drug use
in his hometown.

"Oh my God, yes," he said. From his perspective, "everyone in town
pretty well is hooked on either them Dilaudids or them OxyContins
(which) seems to be the drug of choice now."

The Fredericton centre opened in 2002 as a partnership between the
University of New Brunswick's faculty of nursing and the Fredericton
Emergency Shelters. It addressed the need for a downtown health-care
clinic for drug addicts, the homeless and low-income people. The
methadone clinic, which is a part of it, has been well received.

Methadone is a controversial treatment, and not all drug stores are
willing to get involved. The drug is available in larger centres such
as Fredericton, Saint John, Moncton and Miramichi. But because of the
stigma, and fear of theft, one Fredericton pharmacy added extra
surveillance equipment when it started dispensing the drug.

"You have to be a dedicated pharmacist to want to get into these
programs because clients can take you to the cleaners on the way in
and out the door every day for their methadone," said Margaret
Dykeman, of the UNB faculty of nursing.

Patients are made to drink the methadone, which is generally mixed
with orange juice, on site at the pharmacy or clinic to ensure it
doesn't make its way to the lucrative black market on the street.

In Saint John, the number of people injecting drugs is alarming. AIDS
Saint John's needle exchange program distributes more than 60,000
needles a year. Five years ago, the number was only 750.

"We know we're in a crisis," executive director Julie Dingwell has
said.

The head of the police's street crime unit says Dilaudid pills are
rampant in Saint John. Sgt. Kim Phillips says addicts are so desperate
for the drug they'll do "virtually anything from prostitution to theft
to whatever" to get it.

To combat the problem, he says a cooperative approach must be taken,
one involving the physicians who prescribe the drugs, the pharmacists
who dispense them, the police officers who patrol the streets and the
addicts themselves.

Although some people consider methadone treatment as simply replacing
one drug with another, Sgt. Phillips says he advocates its use.

"I think that it does work in some situations. It works for people who
want the help."

But, he points out that not all addicts want methadone. Some opt to
quit cold turkey.

Dr. Scott Giffin, Saint John's medical health officer, has said
methadone clinics make sense considering the drug problem the region
faces. But the government says it can't afford to provide funding for
a province-wide methadone program that would cost between $2 million
and $6 million annually, including costs for the drugs and required
staffing.

While there's no methadone treatment in Saint John, a support group
meets on the first and third Tuesday of each month. The sessions are
held at 7 p.m. at the Community Health Centre on Coburg Street.