Pubdate: Thu, 04 Jul 2013 Source: Record, The (Kitchener, CN ON) Copyright: 2013 Metroland Media Group Ltd. Contact: http://www.therecord.com/ Details: http://www.mapinc.org/media/225 Author: Terry Pender LONDON HAS CLEAR RULES ON DRUG CLINICS Policy Tries to Balance Need to Help People With Addictions While Limiting Impact on Neighbourhoods KITCHENER - The City of London is way ahead of Kitchener when it comes to controlling and regulating methadone clinics. Eric Lalande, a policy planner in London, said the measures taken there have so far withstood an appeal to the Ontario Municipal Board, a provincial tribunal that rules on land-use disputes. "It is a rising issue in the province of Ontario and it needs to be addressed," Lalande said. Thousands of people are addicted to powerful narcotic painkillers, known as opioids, resulting in at least five deaths a week from overdoses in Ontario. The main source is over-prescribing by doctors, says the Ontario College of Physicians and Surgeons. The doctors' association calls the epidemic in opiod addiction the biggest publichealth concern in Ontario today. Kitchener is looking at how to regulate methadone clinics after it was announced a fourth one was setting up in the city. The latest clinic is a short distance from an existing one and will be the third on King Street East. Currently, methadone clinics can go anywhere medical clinics or pharmacies are allowed in Kitchener. Lalande said the measures taken in London recognize that not all methadone clinics, or pharmacies dispensing methadone, have the same impacts. Lalande said the land-use policies and zoning regulations implemented in London in March 2012 recognize there are two classes of clinics - those serving more than 40 people a day and those serving fewer. The London measures direct the busier methadone clinics to areas of the city dominated by offices, car-dependent development (such as strip malls), institutions (such as hospitals), and increased the minimum number of parking spaces for vehicles and bicycles. London also requires larger waiting rooms for methadone clinics - at least 15 per cent of the building - to reduce the number of people outside the clinics. The clinics must also be close to bus stops. London wants to keep the high-volume clinics out of pedestrian-oriented environments to reduce the potential for conflicts with neighbours and passersby. These clinics must also be at least 300 metres from schools, libraries, pools and arenas. But there are no minimum-distance separation rules in London for methadone clinics locating near residential areas or parks. Lalande said such a measure would force the clinics out of the city, and that would not be a good thing, because lots of people need help quitting opioids. "Since we have implemented the policies, we have had two applications come in," Lalande said. One was approved with a patient limit of up to 200 people a day. The other application for a clinic was denied because it would be within 300 metres of a school. "None of the applications were appealed," Lalande said. London city council passed an interim control bylaw in November 2010. No new clinics were allowed to open for 18 months. That bylaw gave city staff in London time to research how best to plan for clinics and dispensaries. That interim control bylaw was appealed to the Ontario Municipal Board by the owner of a chain of methadone clinics. But the board ruled in the city's favour and the ban on new clinics was upheld while city staff studied the issue. The new zoning regulations and land-use policies went into effect in London in March 2012. As a result of the study, London recognized two types of facilities - methadone clinics and methadone pharmacies. The clinics are where doctors see people trying to quit opioids and write prescriptions and hand out daily dosages of methadone. Some pharmacies dispense methadone to people with prescriptions. "Any pharmacy has a right to dispense methadone," Lalande said. There are 19 pharmacies dispensing methadone in London. Some treated only a single patient, and some up to 30. Clinics and pharmacies seeing more than 40 people a day in London are now considered a separate and distinct land use from regular medical clinics and pharmacies. Lalande said this approach achieves two objectives. Firstly, it recognizes that methadone clinics are needed to help people get out of an addiction to opioids and should be planned for in the city. Secondly, it recognizes there may be land-use impacts on neighbours and the city should be planning to minimize those impacts. The restrictions apply to the large, busy clinics. There are no restrictions on clinics seeing fewer than 40 people a day. "There is a lot of data suggesting these clinics provide a positive benefit, and a lot of the negative stigma received by these clinics may create a barrier to people seeking help," Lalande said. "That's something we are trying to avoid." - --- MAP posted-by: Jay Bergstrom