Doctor Calls Ontario's Methadone Program Opressive and Descriminatory

DOCTOR CALLS ONTARIO'S METHADONE PROGRAM OPRESSIVE AND DESCRIMINATORY

TORONTO - A Toronto doctor says Ontario's methadone program for addicts is "oppressive" in the way it discriminates against patients and forces them to give up their privacy.

Patients who are prescribed methadone for addiction to drugs such as heroin or morphine are shackled to the health-care system and must sign away their privacy rights in exchange for treatment, Dr. Philip Berger told a legislative committee.

The standing committee on social policy is hearing submissions about a bill that would let the province keep tabs on all narcotic drug prescriptions.

Berger, the chief of community medicine at St. Michael's Hospital, has treated addicts for more than 30 years.

He told the committee Monday that he supports the bill because he believes it could help end discrimination against Ontario's 30,000 methadone patients.

"The bill also provides for clear, legal and non-discriminatory authority to confront the misuse of narcotics in Ontario," Berger said in prepared remarks.

"The bill does not single out or target only one group who use narcotics, which is the current situation for patients treated with methadone for narcotic dependency," he added.

The Narcotics Safety and Awareness Act, which has passed second reading, would let the province collect and track information on all narcotics dispensed in Ontario.

That tracking, through doctor's prescriptions to pharmacists, would among other things, determine if a patient is double doctoring.

There would be no need for the Ontario College Physicians and Surgeons to keep its registry of patients taking methadone for addictions, Berger argued, if the government bill passes.

The college's methadone registry can't stop double doctoring because it doesn't include patients who obtain methadone for pain — only addicts who take methadone, he said.

However, a Ministry of Health spokesman said the government database would be separate from the college's registry.

The patient registry is maintained to ensure that no patient is receiving methadone for addiction to opioids from more than one prescriber, college spokeswoman Kathryn Clarke said in an email.

The reality is that a single double dose of methadone can result in a death by overdose, she said.

But Berger said Ontario's methadone program has "a miserably low retention rate" with half of patients quitting within two years of enrolment.

Patients are usually put on methadone for life, he said in an interview, so there's a lost opportunity for treating thousands of addicts.

He blamed in part the program's "discriminatory and intrusive rules" that force patients to visit their doctors monthly and their pharmacies weekly. Patients must provide urine samples witnessed by lab technicians.

Unlike other patients, they must authorize unfettered disclosure of their personal health information to anybody in the health-care system, he said.

He called for changes to the college's program to make it easier for patients to be treated.

Clarke, the college spokeswoman, said the rules make sense.

"The rules that Dr. Berger mentions relate to the methadone treatment guidelines that are developed through a rigorous process of expert consultation and peer review," said Clarke.

They "reflect the views of the addiction medicine community on the safest and best practices for the use of methadone for the treatment of opioid addiction," she said.

In its appearance before the committee Monday, the college called for amendments to the bill and said it hoped doctors would get more information about their patients.

"Ontario is in the midst of a public health crisis — a crisis stemming from the inappropriate prescribing, dispensing and illicit use of opioids and other narcotics," college president Dr. Jack Mandel said in prepared remarks.

The college wants the bill amended so physicians will have access to a patient's narcotics history before prescribing drugs.

Mandel called on the government to quickly develop and implement the planned Drug Information System.


Comes from the Winnipeg Free Press and the Original Link is

http://www.winnipegfreepress.com/life/health/doctor-calls-ontarios-methadone-program-oppressive-and-discriminatory-105215519.html