Methadone & Suboxone

Methadone is a long-acting synthetic opioid agonist (a drug that triggers an action) which is prescribed as a treatment for opioid dependence. An opioid is a drug occurring naturally (heroin or morphine) or produced synthetically (codeine, oxycodone) which is used therapeutically to control pain but which also produces a sensation of euphoria (the narcotic “high”). People who are dependent on opioids may have acquired that dependence through overactive prescription of painkillers or the illegal use of heroin.While methadone is commonly used to control symptoms of withdrawal from heroin it is also an addictive substance. Methadone maintenance treatment (taken orally) remains the most widely used form of treatment for people who are dependent on heroin. Dispensed daily, methadone is a powder which is mixed with orange juice. Initially the dispensation is supervised daily by a physician or pharmacist but once the client has demonstrated an established track record, he or she is provided with several daily dosages (called “carries”). Overdoses of methadone have resulted in deaths.From a harm reduction point of view, methadone is preferred over heroin use because it eliminates the risk of communicable diseases associated with sharing of injection needles and pipes (HIV and HEP C). From an abstinence point of view, withdrawal from methadone is a more difficult process than withdrawal from heroin and is almost impossible unless accompanied by a well structured counseling and support program.Given the stigma associated with attending the methadone clinic, individuals with a dependence to opioids acquired by over-prescription of painkillers have so far found themselves in a very difficult position. In the past 12 months health Canada has approved the use of Suboxone (Buprenorphine Naloxone combination) as a substitute therapy. The drug has been approved in the United States since 2002 and has been prescribed in Europe for at least the past decade. It is both an antagonist (blocks the ability of a given chemical to bind to its receptor, preventing a biological responseO and agonist and consequently does not have the same addictive properties a; methadone. Withdrawal is relatively easier than Methadone but it is of course more a more costly drug that methadone ($7 per dose compared to $.50 for methadone)Dr. Azevedo is one of the first Canadian physicians certified to prescribe the drug. He presently has 15-20 clients on Suboxone (all expcet 1 addicted to pain medications) and reports that they are very alert and even motivated to go to work.

HAEC News

Formerly known as the health alliance of Eastern Ontario, the HAEC is recognized as the LHIN Community of Care for the geographic area of the five counties. The LHIN now requires all funding requests for enhanced or expanded programs be reviewed by both the Community of Care where the program is to be offered and the Community of Practice (if any) affected.

While most Communities judge a program that is not the case with Communities of Care. Recently the HAEC sponsored a strategic planning day which concentrated on presentations by epidemiologists from both the LHIN and the Eastern Ontario Health Unit; these presentations focused on a health status report of the community using a population health approach. The data contained in those presentations reveals once again that alcohol and drug abuse continues to play a large role in the health of the community and has a substantial impact on the health costs incurred in the community. Copies of the presentation should be made available to us shortly. It appears that there is a consensus forming that the HAEC will rank program submissions based on these criteria.

Ministry funding.

For the fiscal period 2007 - 2008 our organization received $1,458,300 as an initial allocation with a base funding increase of 1 1/2% of $19,760, plus an additional stabilization funding of l 1/20/o or $19,800 for a total of $1,497,920. We have just received a payment notice for the fiscal period 2008 - 2009 which sets our annual allocation at $1,450,360 and completely ignores last year’s gains. Clarification is being sought.

New street drug.

Popular in the Alexandria area, the Beanie is a small pink pill now available in Cornwall for the cost of $1 per unit. It is a combination of LSD, methamphetamine and caffeine. The tranquilizing benefits of Diazepam have reportedly not been experience with this new drug.

Needle exchange service.

The OATC clinic (the Cornwall methadone clinic) located on Marlborough at 5th St is now dispensing needle kits which include a tourniquet, saline solution, a “cooker”, a filter and the needle. This is an attempt to reduce the harm of HIV and HEP C to those opiate addicts who are not yet ready to switch to methadone.

Adolescents and adults - different drinking patterns.

Underage drinkers typically have not developed regular patterns of drinking and so are likely to exhibit situational variation in alcohol intake, including binge drinking. Underage drinking contributes to the 3 leading causes of death (unintentional injury, homicide, and suicide) among persons aged 12 to 20 years. Most adverse health effects from underage drinking stem from acute intoxication resulting from binge drinking. Students who binge drink are more likely than both nondrinkers and current drinkers who do not binge to report poor school performance and involvement in other health risk behaviors such as riding with a driver who had been drinking, being currently sexually active, smoking cigarettes or cigars, being a victim of dating violence, attempting suicide, and using illicit drugs. A strong dose-response relationship was found between the frequency of binge drinking and the prevalence of other health risk behaviors.The well accepted adult premise that when the costs outweigh the benefits of substance abuse the resulting discomfort can be a catalyst for change does not seem to apply to adolescents or even college age students. Rather in that age category the presence of anxiety and depression (independent of a well-established drinking pattern) seem to be the best catalysts.Call Wholistic Health Wellness for more information 575-2341