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What's he saying? The truth about methadone

There's been a lot of talk lately by the minister of justice about methadone maintenance therapy and the Whitehorse Correctional Centre. The issue is the decision by the Justice Department in 2012 to stop methadone treatment for prisoners

by Patricia Bacon

There’s been a lot of talk lately by the minister of justice about methadone maintenance therapy and the Whitehorse Correctional Centre. The issue is the decision by the Justice Department in 2012 to stop methadone treatment for prisoners and without the consent of the prisoners, force them into medical detox.

Minister Mike Nixon gives three reasons for his decision: 1) that the people who were on methadone therapy when entering WCC were using more than one drug creating a potentially “lethal” situation; 2) that WCC doesn’t have the qualified staff to administer the program; and 3) that prisoners given methadone can vomit it up and sell it to other prisoners.

Let’s take a closer look at his reasons and translate them into something real for readers.

On the issue of using more than one drug (poly-substance use) and the risks with giving methadone to someone using multiple drugs, the minister’s statements fail to recognize available science and the best practice guidelines. According to Health Canada, it is very common among people who are addicted to opioids to also use other drugs including marijuana and cocaine.

Best practice guidelines state that while multiple drug use is not ideal, we should manage it through individualized health plans rather than deny treatment. This is current practice in both community settings and other jails in Canada.

The reality of the likelihood of multiple drug usage by people on methadone must be well understood. The minister’s position that poly-substance use makes methadone treatment impossible in a prison setting suggests that WCC isn’t able to provide the same standard of care as other facilities across Canada.

Is this the message the minister wants Yukoners to have? That WCC is unable to meet basic standards of health and safety that are on par with other jails in Canada?

On the issue of no qualified staff: the WCC does not have qualified staff because they stopped the methadone program in March 2012. Staff that were qualified have since left WCC. New staff

haven’t been required to become qualified in methadone management because there is no program.

However, the WCC would have qualified staff if they had a methadone policy because the jail would provide training to the current staff or hire appropriately trained staff. The argument that this cannot be done because there are no qualified people to do the work suggests that the WCC never has or never adopts any policies that ever require any type of training.

Is this the message the minister wants Yukoners to have? That WCC is unable to meet standards of health and safety because they do not have any training protocols for its staff?

Finally, I apologize for raising the issue of regurgitation when you, dear reader, might be trying to enjoy your morning muffin - however since the minister raised it…

Methadone is a drug that is given in liquid form under the supervision of a pharmacist or nurse. Small amounts of liquid is metabolized in the body fairly quickly. Previously consumed methadone does not become a currency in prison if the drug is taken in the presence of a health professional, away from other prisoners, and the prisoner is monitored for a short period before being taken back to the cells.

It is a supervision issue. Is this the message the minister wants Yukoners to have? That WCC is unable to meet basic standards of supervision?

It is not dangerous to give methadone to people who are in jail. It is a standard of practice in all prisons and jails across Canada, with the exception of the WCC.

Methadone maintenance therapy is recognized as a legitimate health treatment intervention that stabilizes lives, reduces risk of HIV and hepatitis C, and has better long-term treatment success than detox. Methadone maintenance is also highly effective in reducing criminality and recidivism.

Isn’t that something the minister could get behind? His excuses for not providing methadone to Yukoners in jail are short on evidence and long on hyperbole.

Patricia Bacon is executive director of Blood Ties Four Directions Centre.



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