Pubdate: Wed, 10 Sep 2008
Source: Province, The (CN BC)
Copyright: 2008 Canwest Publishing Inc.
Contact: http://www.canada.com/theprovince/letters.html
Website: http://www.canada.com/theprovince/
Details: http://www.mapinc.org/media/476
Author: Susan Lazaruk

DOCTORS CALL METHADONE KICKBACKS A 'BIG PROBLEM'

Nearly $18 Paid For Each Methadone Dose Dispensed

Addictions doctors in Vancouver's Downtown Eastside have complained 
for months about pharmacists luring heroin addicts for their 
lucrative methadone prescriptions, and say rules around dispensing 
fees have to change.

"A lot of doctors have been frustrated by this," said Dr. Stan 
deVlaming, medical director for Inner City Primary Health Care for 
Vancouver Coastal Health Authority. "There have been numerous 
complaints spread over months for at least a year. . . It's a big 
problem, not a small one."

Heroin addicts prescribed methadone, which quells cravings, are 
getting kickbacks for filling their prescriptions at certain 
pharmacies, particularly in the Downtown Eastside and in Whalley's 
downtown in Surrey.

Offering incentives is against PharmaCare rules and the B.C. College 
of Pharmacists and B.C. Health are investigating.

Addicts must pick up their methadone doses daily. It's a lucrative 
business for pharmacists, who collect $8.60 in daily dispensing fees 
and $7.70 for witnessing the ingestion, in addition to the $1.40 in 
reimbursement for the drug.

Supplying the 8,400 methadone users in B.C. could cost taxpayers up 
to $54 million a year.

Dan Russell, 31, a construction worker prescribed methadone for about 
six months a year ago, said he was paid $5 to $10 and sometimes $20 
for patronizing a certain pharmacy. He said he could get it delivered 
and no one would know if he ingested it.

DeVlaming said pharmacists have also urged methadone users to ask 
doctors for daily doses of other drugs, including Tylenol or 
ibuprofen, to collect daily dispensing fees.

If the doctor objects, the pharmacists counsel the patient to change 
doctors, he said.

DeVlaming said the methadone maintenance program should be revamped. 
He also suggested having government-run pharmacies to serve users.
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MAP posted-by: Keith Brilhart