Pubdate: Thu, 22 Dec 2011
Source: Telegraph-Journal (Saint John, CN NK)
Copyright: 2011 Brunswick News Inc.
Author: Karissa Donkin
Bookmark: (Methadone)


Health: Province Plans to Limit Travel Subsidies to 18 Months for 
Patients Attending Daily Clinics

SAINT JOHN - Craig McInnis spends about $210 every month to make the 
daily journey from his home near the Saint John airport to Prince 
Edward Guardian Pharmacy to take his dose of methadone.

He arrives at the clinic, tucked away at the back of the pharmacy, 
sits on a chair and waits.

There isn't much to look at on the walls, except for shapes cut from 
bristol board, posted to remind patients how to behave: be 
respectful, leave pets outside and if you come without a way to pay 
for your dose, you don't get your drink.

When it's ready, he downs his methadone mixed with orange juice.

McInnis is addicted to Dilaudid, a painkiller often prescribed after 
surgery. He spent a year on methadone and thought he recovered from 
his addiction, but he had to go back on the program last March.

The drug doesn't make him high like Dilaudid does but it helps him 
deal with the cravings and sickness that comes with withdrawal.

In 18 months, if McInnis hasn't recovered, he may not be able to make 
it to his daily treatments.

The provincial government has launched a new methadone maintenance 
benefit program that sets an 18-month limit on how long methadone 
patients can receive travel benefits to get back and forth to the 
pharmacy every day.

The new policy has also capped the benefits, which can include bus 
passes or reimbursements for gas or taxis, at $200 a month.

Department of Social Development spokesman Mark Barbour said the 
policy changed because the old one was "all over the map" and the 
number of people using it has been increasing.

In 2004, 181 people used the travel expenses, compared to 1,328 people in 2011.

"This level of growth is unsustainable, hence why we've decided to 
put a cap on it of $200 a month for over 18 months," Barbour said.

He couldn't say how much the department is saving by changing the policy.

"The savings that we're finding are not measured out in dollars.

"They're measured out in terms of sustainability for the travel 
program in a whole for all New Brunswickers that need the help."

McInnis receives $100 a month to pay for his travel to get his 
methadone. If he doesn't have a job when his time with travel 
benefits runs out - he finds it hard to work until he's closer to the 
end of his treatment - he isn't sure he'll be able to get to his methadone.

"It's not right. If people need help, they need help. We all need 
help just the same as if you've got another health problem. It is a disease."

The department set the time limit at 18 months, Barbour said, because 
it's "an agreed upon requirement of time to stabilize somebody and 
have them recover."

He said the longest someone has been on methadone and receiving the 
travel benefits is seven years and he questioned whether someone 
would need to be on it for even three years.

Setting the time limit, he added, is an incentive for clients to not 
miss any doses and finish the program.

"Individual cases can and will be reviewed at the 18 month point to 
determine whether the travel expense will continue to be covered."

But Julie Dingwell, executive director of AIDS Saint John, said 
recovery time depends on the person.

"The optimum we know from studies around the world for people to be 
on methadone minimally is two years," she said.

"To suggest that people will get in and get out in 18 months, that's 
not based on any science. That's based on a wish of the department to 
cut back spending, but it's not based on reality."

Dingwell questioned who the government expects to pick up the cost of 
addicts' transportation to methadone clinics once they reach the 
18-month limit. They could die if they miss more than three doses and 
keep taking the treatment, she said, because their bodies build up a 
tolerance to it.

"If they come off methadone before they're ready to come off 
methadone, it's possible that they'll return to the life they had before.

"If we're to be judged by how we treat the most vulnerable among us, 
we're not going to be judged very well in New Brunswick."
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MAP posted-by: Jay Bergstrom