Pubdate: Fri, 27 Jul 2001
Source: Sault Star, The (CN ON)
Copyright: 2001 The Sault Star
Contact:  http://www.saultstar.com/
Details: http://www.mapinc.org/media/1071
Author: Frank Dobrovnik
Bookmark: http://www.mapinc.org/find?136 (Methadone)

ANOTHER LOCAL DEATH LINKED TO MORPHINE

While community service agencies study establishing methadone treatment 
locally, another sudden death in Sault Ste. Marie has been added to a 
mysterious cluster the Ontario chief coroner's office is investigating as 
morphine-related. A sudden death in June is now being looked at in relation 
to 12 local deaths since October 1999, confirmed deputy chief coroner Dr. 
Jim Cairns.

"It's being investigated, as they all are, in its own right, as a single 
death, but it's also being investigated to see if there's anything 
regarding the circumstances of that death that may tie in to the other 
deaths," Cairns said Thursday.

Citing confidentiality rules, he would not reveal details about the victim 
or circumstances of the death.

But he said some aspects of the latest death may "be of help in resolving 
some of the issues" that have so far kept investigators from solving the 
other 12 deaths. He expects firmer results in about a month's time.

"There are some similarities but that's all at this time it would be 
accurate for me to say," he said.

"There are some things here that we may know more about than we did in some 
of the others . . .

There's a line of inquiry that's ongoing that may be fruitful, but it's too 
early to say."

One of the theories being pursued is whether the victims _ those confirmed 
are 10 men and two women _ received morphine from the same source.

Cairns said investigators are no closer to confirming that but he hopes the 
question will eventually be answered.

A few facts have emerged since April, when the chief coroner's office took 
the investigation over from the regional coroner in northwest Ontario and 
the Sault Ste. Marie Police Service to see if new patterns could be gleaned 
from a different perspective.

As reported in January, morphine has been confirmed as the primary cause of 
death in only one of the victims.

The drug has been attributed as a contributing factor to natural disease in 
five other cases. Four of those were determined to have been prescribed 
morphine legally for ailments such as chronic back pain.

In contrast to earlier suspicions, injection is not the preferred method of 
administering the drug. Injection has been determined in only five cases so 
far.

Six were found to be known drug abusers, and several of the victims, aged 
between 30 and 50, were at least acquaintances.

Meanwhile, a committee of community service providers met for the first 
time Wednesday to study the feasibility of methadone maintenance treatment 
(MMT) in Algoma District to combat morphine addiction.

Traditionally, addiction to painkillers _ largely heroin but also morphine 
_ has been treated through methadone, a synthetic opioid that helps 
suppress withdrawal symptoms and can be regulated to prevent euphoric or 
sedative side-effects.

According to the CAMH, the number of Ontario patients involved in MMT has 
been increasing dramatically _ from 770 in January 1996 to more than 5,000 
four years later.

But several communities, including the Sault, offer no methadone treatment 
services outside correctional services.

The nearest centre is Sudbury, which has only one physician licensed to 
prescribe methadone. As of June 2000, only 118 physicians were actively 
prescribing methadone for the purposes of MMT in all of Ontario.

So far the committee has representation from the Centre for Addiction and 
Mental Health, the Algoma Health Unit, the John Howard Society, Addiction 
Treatment and Prevention Services of Algoma, Ontario Works, a local 
pharmacist, a local family physician and a local provider of laboratory 
services.

The committee is partly a result of a directive of the Ontario Substance 
Abuse Bureau, an arm of the provincial health ministry that funds addiction 
treatment agencies such as the CAMH.

The committee also grew out of the work of Addiction Treatment and 
Prevention Services of Algoma, which in May released an information 
pamphlet offering tips for safer injection drug use.

Committee chair and CAMH program director Mike O'Shea said the need for MMT 
has been proven but recruiting a family physician here for that purpose is 
a daunting task.

"It's more of a resource barrier to service, in terms of finding a 
physician who might be interested in providing the service," he said.

"It's kind of a difficult sell to tell a physician who's already run off 
his feet he should be looking at this kind of treatment."

He added that MMT involves more than just a physician _ a number of 
community supports need to be established to methadone patients, such as 
counselling and follow-up. He does not expect service this year, even if it 
is determined to be feasible.
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MAP posted-by: GD