SECOND METHADONE CLINIC OPENS

Five Doctors Will Eventually Staff John Street Facility For People With
Opiate Addictions

Jane Woods-Clark doesn't doubt for a second that methadone saved her life.

Years ago, when she first tried to get the drug that would quell her
desperate cravings for heroin, she couldn't get the help she needed. There
were too few doctors for too many addicts.

"You really had to wait for someone to die or drop off the face of the
earth," she said.

"I had been wanting to get off for years. I couldn't stand it any more. I
couldn't stand living like that anymore."

She was one of a long lineup of patients at Dr. Gary Jollymore's door when
he opened Hamilton's first methadone clinic in 1996. She's been on
methadone, and free from 20 years of heroin addiction, ever since.

"I have a life now," said Woods-Clark, chair of the city's methadone
advocacy working group.

Many others haven't had that chance because until now, only three doctors
in Hamilton prescribed methadone for hundreds of people addicted to heroin
and other opiates such as morphine.

That should change Wednesday when another methadone clinic opens in
downtown Hamilton.

First Step, on John Street North, will eventually have five doctors
specializing in opiate addiction and methadone maintenance treatment.
Methadone, a synthetic narcotic, allows addicts to function normally by
ending their cravings without giving them dizzying highs or painful lows.

There is a shortage of physicians throughout Ontario who prescribe
methadone, which is taken in a daily oral dose. Addiction experts say the
addition of five physicians in Hamilton is great news.

"In any community, the addition of one doctor can be a major coup," said
Mark Erdelyan of the provincial Centre for Addiction and Mental Health.

Jollymore said his clinic can't keep up with the demand.

He has about 275 patients, some from as far away as Windsor and Niagara
Falls, with another 30 on a waiting list.

Woods-Clark estimates there are hundreds more who need methadone.

"I welcome (First Step). They're desperately needed," she said.

Komal Khosla of First Step, which has three other clinics in the province,
said they wanted to set up in Hamilton because they'd been told about the
demand by referral agencies.

They expect to treat about 400 or 500 patients.

"There's an unbelievable number of people out there with these addictions,"
he said.

Jollymore, who prescribes methadone six days a week at a clinic on Main
Street West, said he sees people from all professions and walks of life.

About half are addicted to the street drug heroin and the other half to
opiates like the prescription drug Dilaudid and, most recently, Oxycocete.

Those are ground up, mixed with a solution and injected for a rush of
euphoria, followed by hours of peaceful sedation.

Addicts get the prescription drugs through doctor shopping or prescription
fraud or on the street.

If treatment isn't readily available, people will simply continue to use,
Jollymore said.

And if people are using, they can turn to crime to support their habit and
pass on disease by sharing needles.

"People who need (treatment) are more likely to go get it if it's made
available," he said, adding that if people want treatment but can't find
it, it can be detrimental.

"It's a very major step to accept (having the addiction) and go get
treatment. If they're turned away, that's a fairly significant blow."

Doctors often don't want to prescribe methadone because they're already too
busy, they don't want to add "junkies" to their family practices, they have
trouble getting insurance or they don't want to take on the constant
demands of someone with a chemical dependency.

To prescribe methadone, doctors must take a one-day workshop and two days
of clinical training.

There are 159 physicians in Ontario prescribing methadone for 11,575
patients. In 1996, there were only 40 physicians for 600 patients.

Critics don't like methadone because, they say, it replaces one addiction
with another.

Some people remain on methadone all their lives.

But Jollymore said he regards it as treating a disease like any other.

He said it's very satisfying to treat people with methadone because the
drug is so effective.

"You can see people get better almost in front of your eyes," he said,
adding that when they first come in, they look sick and dishevelled.

There are track marks up and down their arms and necks.

"Within two weeks, they're clean, tidy, polite."

You can contact Cheryl Stepan at cstepan@hamiltonspectator.com or at
905-526-3235.

Methadone eliminates craving

* First Step, which opens Wednesday, is a clinic specializing in methadone
treatment and counselling for people addicted to heroin or other opiates,
such as morphine, Percocet or Dilaudid. Doctors at the John Street North
clinic will also offer methadone treatment for people suffering from
chronic pain, as well as treatment for hepatitis C, which is common among
intravenous drug users. The clinic has a pharmacy. First Step started in
Toronto in 1997 and has opened other locations in Scarborough and Oshawa.

* Methadone is an opiate that ends an addict's craving but, unlike heroin,
does not cause the euphoric highs and painful lows. It involves daily oral
doses of the liquid drug which last 24 to 36 hours. At first, people on
methadone must go to a pharmacy each day to drink their dose under the
supervision of a pharmacist. As they become stabilized, they are allowed
take-home methadone. Doctor's visits are covered by OHIP. The methadone is
paid for by the customer or a drug insurance plan if they have one.

* In 1996, the responsibility for methadone treatment shifted from the
federal government to provincial health authorities.

The rules became much more flexible, so more physicians began to prescribe
the drug. In 1996, 40 doctors were prescribing methadone for 600 patients.
Today, 159 doctors prescribe for 11,575 registered patients.