CORKTOWN: THE PANIC IN NEEDLE PARK

When a methadone clinic moved into the historic area east of downtown
last year, the locals didn't exactly roll out the Welcome Wagon.
Residents don't feel safe. Patients report intimidation. It's one
heck of a thorny issue to resolve, writes MELISSA WHETSTONE

When Suzanne Edmonds envisioned the revitalization of Sackville Park
- -- children playing on a new swing set, families picnicking amid lush
greenery -- methadone patients were not part of the pretty picture.
Neither were vomit on the sidewalk, needles in the grass or groups of
drug users.

But since a methadone clinic opened its doors across the street from
the park last July, the past president of the Corktown Residents and
Business Association says this is what she and other residents have
been witnessing.

"Several of us were [in the park] one day setting up for a community
event . . . and there were people using the water fountain to wash
their unmentionables," Ms. Edmonds says. "People were using the
children's wading pool as a bathtub."

Emotions are running high in Corktown. The methadone clinic sits next
door to the Little Trinity Anglican Church, built in 1843, the oldest
standing church in Toronto. The area bounded by Shuter Street, the
Don River, Lake Shore Boulevard and Berkeley Street is home to a mix
of single, young professionals attracted to the convenient downtown
location and affordable housing, and older families that have called
Corktown home for years.

Right now, the small neighbourhood has just a few low-rise lofts and
a couple hundred houses, many of which date back to the 1800s -- but
development is nibbling around the edges. It's an area rich in
history, and the CRBA, for one, feels a methadone clinic doesn't belong.

"We are absolutely outraged that a heritage community -- a heritage
building in a heritage community -- could have this use," Ms. Edmonds says.

Outside the Corktown clinic near King and Trinity Streets on a recent
Saturday morning, the silence surrounding the brown brick building is
broken by a passing streetcar. There is nothing to indicate this is
an addiction treatment clinic. Inside is no different. Friendly
chatter fills the waiting room, a woman taps her foot to the Bryan
Adams song playing in the background, and a pile of flyers
advertising a monthly support group sits on the counter.

Kumar Gupta, a doctor at the clinic who has been practising addiction
medicine since 1997, says residents are overreacting and that the
patients are the ones who feel threatened.

"Many of my patients reported to me name-calling and many had their
pictures taken by members of the community as an intimidation tactic
to scare them away," he says.

"Two weeks ago, a patient of mine came back to my office teary-eyed
after a community member told him to go back where he belongs and to
get out of the community. . . . The resident told the patient: 'You
know, you're ruining our community,' " Dr. Gupta says.

Before coming to Corktown, the clinic made its home for 15 years a
short distance away on Front Street, just east of Jarvis, until the
number of patients outgrew the small facility. Because the majority
of patients live in the downtown area and walk or take public
transit, it was important to maintain an accessible site, Dr. Gupta
says. The Corktown location meant an easier transition.

Methadone, consumed orally as a liquid, is used to treat people
addicted to heroin and opiate-based narcotics. It helps prevent
patients' withdrawal symptoms and reduce cravings. But, as Dr. Gupta
explains, writing methadone prescriptions isn't the clinic's only activity.

"We have peer support workers here who are counselling them. We have
a liver specialist here who helps with their hepatitis C. We have
nurse practitioners here as well. We have a pain specialist here if
they have underlying pain issues," Dr. Gupta says. "We're dealing
with a multi-comprehensive medical discipline."

Ms. Edmonds and the CRBA delivered a community impact statement in
January to the province's Methadone Maintenance Treatment Practices
Task Force and Health Minister George Smitherman. The task force's
mandate is to advise the Health Ministry of the best approaches to treatment.

The CRBA's impact statement says that "residents no longer feel safe"
and "community members are openly threatened and intimidated" by
patients of the clinic.

Steve Behal, who owns a photography business across from the clinic
and walks his dog daily, says he is shocked by what he has seen.

"I have been in the park where someone has walked down the street
from the methadone clinic and is writhing in pain in the grass while
his friend is pacing back and forth," he says.

When the wading pool was empty, "I have been there when a man gets
off a bicycle, takes off his clothes, strips down to his underwear,
takes out a bar of soap and washes in the drips from the pipe," says Mr. Behal.

Local police say it's not clear that safety has declined. Community
Affairs Staff Sergeant Frank Bergen of 51 Division has compared crime
patterns from a year prior to the clinic's arrival to those of the
period after the clinic opened in July 2006. He says the clinic has
had "no measurable effect on the community."

Police monitor the area daily, Staff Sgt. Bergen adds, and he has
been inside the clinic several times. He describes the facility as
clean, inside and out, but he has "seen remnants of vomit [the
residents] speak of . . . outside the clinic."

Staff Sgt. Bergen, who attended January's meeting, believes progress
between the residents and members of the clinic "is going well in
that there is communication going back and forth."

Dr. Gupta, who is also a member of the task force, wants to continue
that process, stressing he is not trying to paint the community
negatively and is sympathetic to its fears.

"When we came, obviously there was fear, and I think the fear turned
into hostility, and that's understandable because everyone is afraid
of the unknown."

Ms. Edmonds, too, says residents feel compassion for the patients and
that the CRBA's recommendations stem from the residents' desire to
see patients get the best possible treatment.

"I believe we are our brother's keeper. I believe that deeply," Ms.
Edmonds says.

Recommendations include mandatory community consultation, bylaws to
dictate where such facilities can be placed, a cap on the number of
patients that can use each facility and measures to ensure patients
have full access to counselling.

One of the CRBA's main concerns is that there is no clear authority
over methadone clinics.

The College of Physicians and Surgeons is in charge of administering
the methadone program in co-operation with the Centre for Addiction
and Mental Health and the College of Pharmacists, and on behalf of
the Ministry of Health, says Kathryn Clarke, a spokesperson for the College.

According to the College, there are 157 physicians certified to
provide methadone treatment in Toronto and 3,300 patients.

Doctors who want to prescribe methadone must be granted an exemption
and pass the College's screening process. Doctors are then assessed
within a year, Ms. Clarke says.

Dr. Gupta, who sits on the College's methadone committee, believes
that the task force, which is expected to issue its report by the end
of the month, is adding to the College's remarkable work.

"One of the positive things the task force is doing is helping any
new clinic specializing in addiction medicine . . . [determine] how
to communicate well with the community before they move in . . . and
what steps a clinic can take to ensure that the community will be
safe and work well with the clinic."

In the meantime, Corktown residents will continue to share their
neighbourhood's streets and park with patients from the clinic and,
although the past year has been marred by accusations and anger, Dr.
Gupta remains optimistic.

"Time does heal," he says, "and I think the community is realizing
this clinic is not creating a problem."