Pubdate: Sat, 19 Nov 2011
Source: Telegraph-Journal (Saint John, CN NK)
Copyright: 2011 Brunswick News Inc.
Contact: http://telegraphjournal.canadaeast.com/onsite.php?page=contact
Website: http://telegraphjournal.canadaeast.com/
Details: http://www.mapinc.org/media/2878
Author: April Cunningham
Bookmark: http://www.mapinc.org/find?136 (Methadone)

DRUG CLINIC RESULTS EXCEPTIONAL

Health: Retention rate in project is double Vancouver's

SAINT JOHN - The uptown methadone clinic is leading the country in 
its retention rates, and could serve to be a model across the globe, 
says a researcher with the Horizon Health Network.

Operating out of the St. Joseph's Community Health Centre, it is one 
of two methadone clinics in the city, and in its first year of 
operation 95 per cent of participants stayed. That is more than 
double the rate in Vancouver's program, said Tim Christie, director 
of ethics for Horizon.

The program - which also saw reduced crime and cocaine use - is 
"absolutely" among the top methadone services in Canada, he said.

"The results speak for themselves."

Christie revealed the results of his study at the International Drug 
Policy Reform Conference in Los Angeles earlier this month. He was 
one of two Canadian researchers invited to the conference, which was 
also attended by academics from Ukraine, Australia, and the U.K.

"People are astounded," he said, and other health services are 
interested in introducing a similar model.

The program in uptown Saint John is different because there are no 
barriers to accessing treatment - such as psychological assessments - 
and someone can't be kicked out. There is also no mandatory 
counselling component, which is a requirement for the methadone 
program at Ridgewood Addiction Services. In 2009, 179 patients were 
enrolled at the St. Joseph's clinic.

Christie's research also evaluated three other key indicators of 
success: illicit drug use, crime and costs.

Urine tests from the first six months and last three months of the 
program show there was a 66 per cent increase in the number of 
methadone patients who stopped using illicit opiates, such as 
OxyContin and Dilaudid, and there was a 13 per cent increase in the 
number of who stoped cocaine, according to the tests.

The cocaine link was particularly telling because methadone has no 
biological effects on cocaine use.

Christie said the results suggest methadone stabilizes people's 
lives, so they aren't as likely to abuse other drugs.

"When people don't have to engage in that drug-seeking behaviour, 
they use their time very constructively," he said.

Crime was reduced by 62 per cent among the patients who used the 
clinic in its first year. Christie suggested the crime patients were 
involved in may have been outstanding from before they enrolled in the program.

"The type of crimes are nowhere near as concerning as when people 
were untreated, and the level of desperation is nowhere near the 
same," he said.

Saint John Police Chief Bill Reid has said the methadone clinic has 
helped reduce robberies in the city by half, for example.

Finally, Christie found that the costs of treatment were far less 
than the cost of allowing an addict to go untreated.

 From 2009 to 2010, the province spent a little more than $1 million 
to treat 173 people.

But Christie said when you consider the health care, social and 
criminal costs of an untreated addict, it adds up to $49,000 a year 
per person. So the total cost of leaving those 173 people untreated 
would be roughly $8.5 million.

"If you keep people in treatment, they don't have to do all these 
things to buy illicit drugs," he said.

The cost of running the uptown program has decreased since 2009, 
because the province has lowered pharmacist dispensing fees.

The fees still make up the majority of the cost of each dose.

Christie said more research is needed to pinpoint why the program's 
retention rates - considered the most important measurement - are so 
successful.

But he said the treatment philosophy of the clinic is really 
beneficial, the staff are accepting of people's treatment plans, and 
there is no involuntary discharge policy. The clinic also offers 
primary care, is centrally located and connects patients to other 
health services.

Julie Dingwell, a long-time proponent of the program and the 
executive director of AIDS Saint John, called the research "brilliant."

"It says that it was important to get this (program) in place. The 
need was great. The need is greater than what we're able to provide, 
actually," she said. The waiting list for methadone treatment at the 
clinic is consistently more than 300.

"I would think you've just got to look at the reduction in crime to 
know that people's lives are changing drastically," she said.

Methadone is a maintenance treatment provided to stabilize the lives 
of people addicted to opiate drugs, including prescription pills and heroin.

The uptown clinic provides people with a prescription which they fill 
at participating pharmacies.

Christie's research paper has been submitted to the Canadian Medical 
Association Journal for peer review.
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MAP posted-by: Jay Bergstrom