Tuesday, February 5, 2013

One Point of View


On Monday, we got together with the BC Association of People on Methadone (BCAPOM) and VANDU to launch our new Methadone Patient’s Rights Card in front of the Executive Airport Plaza in Richmond.  Inside, provincial health authorities and addictions researchers were meeting to discuss how to improve methadone treatment in B.C.

As of last year, 13,894 people in the province were on Methadone Maintenance Treatment program (MMT).  Members of BCAPOM wanted to express to those in the meeting and the public that it is necessary for decision makers in government to hear from actual methadone patients when discussing how to improve and fix the MMT program.

1297369718644_ORIGINAL.jpgMMT delivery in British Columbia has been criticized for many years by BCAPOM as a system fraught with corruption and stigmatizing to those it is intended to help.

There are a lot of misconceptions about methadone. Even a fairly sympathetic story in the 24 Hours newspaper covering the launch of the rights cards perpetuated the idea that accessing methadone is more akin to illegal drug-seeking activities than to accessing other prescriptions for chronic conditions. They ran the story with the opening line “Methadone users having trouble getting their fix have a new method to report complaints …”

Stigma and misunderstandings about the nature of MMT, combined with the fact that methadone can be a very lucrative niche market for pharmacists and doctors, has resulted in a situation where people who are prescribed methadone face discrimination, exploitation and unreasonable limits on their ability to manage their own health. The most highly publicized methadone scandal in B.C. in recent years was the case of George Wolsey, the former pharmacist and SRO hotel owner who, among other things, forced his tenants to get their methadone prescriptions filled at his pharmacy under threat of eviction.

While the Wolsey case was an extreme example of exploitative practices, patient stories of abuse and concerns about the quality of service they receive are common. Complaints range from being treated disrespectfully to receiving watered-down medicine. Even long-term, very stable methadone users face restrictions on travel because they are not allowed to carry doses of their prescriptions with them (leading some methadone patients to refer to the treatment as “liquid handcuffs”). There are also many examples of patients having their prescriptions reduced or cut off by their doctor for “non-compliance,” which includes missing doses, not renewing prescriptions in a timely fashion, or experiencing a relapse. These issues are not only a problem in terms of patients’ rights, they also undermine the very goal of MMT, which is to reduce the harms associated with opiate addiction by retaining patients in the treatment program.

In response to the case of Mr. Wolsey, Vancouver City Council set up a task force to look at abuses in the delivery of MMT. We worked with the task force over the past year and a half, and the City supported Pivot and BCAPOM to produce and print 10,000 rights cards.

We believe that knowing your rights is the first step to advocating for and upholding those rights. The cards are meant to help methadone users confront unfair physician and pharmacist practices, as well as offer guidance for filing complaints with the regulatory bodies that control MMT. BCAPOM and VANDU have included their contact information on the cards and will help patients file complaints. However, we know that there is still a long way to go to improve B.C.’s MMT system. Not only can the complaint process be onerous for marginalized populations even with support, there also needs to be an effort to break down the stigma that is still attached to methadone among health care providers and the general public, and to ensure that patients accessing the program have a seat at the table in discussions about the nature and delivery of their healthcare.

Check out the rights card here

And, take a look at this story in Tuesday’s Globe and Mail about the cards, including an interview with BCAPOM member Laura Shaver about her experiences as a MMT patient.

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Scott Bernstein

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