Pubdate: Tue, 16 Oct 2007 Source: Maple Ridge Times (CN BC) Copyright: 2007 Lower Mainland Publishing Group Inc Contact: http://www.mrtimes.com/ Details: http://www.mapinc.org/media/1372 Author: Maria Rantanen, The Times Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/find?136 (Methadone) HEROIN ADDICTS HIT THE ROAD TO KICK IT Addicts Likely to Relapse, Says Head of Addictions Program, Because They Have to Take a Bus -- or Worse Hitchhike -- to Get Access to Methadone. Heroin addicts in Maple Ridge and Pitt Meadows who want to get clean and onto a methadone program usually travel to Mission, New Westminster or Vancouver to get their prescription, putting them at serious risk of relapsing, because there are no local "methadone maintenance" clinics. Ron Lawrence, executive director of Alouette Addictions in Maple Ridge, estimated his centre has about 45 to 50 clients who need to commute to clinics outside Maple Ridge and Pitt Meadows to pick up their methadone prescription. Commuting, though, might mean hitchhiking, taking the bus, SkyTrain or West Coast Express, and all these increase the risk of going back to heroin use. "Most SkyTrain stations have drug dealers," said Dimitry Noel-Bentley, clinical supervisor at Alouette Addictions. In addition to coming in contact with dealers, public transportation can be unreliable and can compromise the patient-doctor trust, which is crucial for methadone maintenance, Lawrence said. When an addict misses an appointment for his or her methadone prescription, the doctor doesn't know what the reason is. "They're late getting in. Then they don't get their methadone dose and they start getting sick; then they turn back to heroin," Lawrence said. "The doctor has no way of knowing how well they're doing." When addicts are first put on methadone, they often need to see their doctor several times a week to see how the dose is working and for the doctor to monitor that they aren't back on heroin. This means they're going back and forth between home and the clinic. Lawrence said it's also important for counsellors and doctors to be in contact with each other about the addict's treatment. "The counselling really needs to be attached to (the medical treatment) in order of it to be a successful program," said Lawrence. "If they're attached to the same place, then they'd get the counselling and the methadone or whatever other medication they need. When they're working in the same agency...they can fairly easily share information back and forth." After an extensive survey of agencies and the community at large, the Maple Ridge-Pitt Meadows Substance Misuse Prevention Task Force gave 33 recommendations last spring, and one was to provide "local access to methadone maintenance." The Fraser Health Authority's mental health and addictions department is also working to identify "gaps in methadone service," according to Andy Libbiter, director of the department. "We're conducting an analysis right across Fraser Health now looking at all communities to get data and trying to establish where the gaps are," Libbiter said. After this "gap analysis," Libbiter said the Fraser Health Authority will "formulate some kind of response." "There are prescribing methadone doctors here in Maple Ridge, but there is no centralized system," Lawrence said. And finding them is no easy task. The B.C. College of Physicians and Surgeons holds a one-day Methadone 101 course and follow-up sessions with doctors who want to prescribe methadone, but they don't give out the names of those doctors. If someone wants to find a doctor prescribing methadone, the College sends them to regional clinic, which charge between $60 and $65 monthly for an assessment by a counsellor and a doctor, and follow-up appointments with a counsellor. - --- MAP posted-by: Richard Lake