In Whitehorse, a bottle of Tylenol 3s relieves a lot more than pain.
On the street, it’ll fetch $30 bucks, a pouch of tobacco or a rock of crack.
And it’s easy to come by.
“Whatever you want, or whatever you’re on, the doctors just give them away like candy,” said Sam (not his real name).
Struggling with fetal alcohol spectrum disorder, the 30-year-old man dealt pills regularly for more than three years.
He gets them free with his native status card.
“Whenever I need money, I just do that,” he said.
“It’s fast cash.”
And Sam could prove it.
On Wednesday, he headed to one of the city’s three walk-in clinics.
Ten minutes later he left the clinic grinning.
He bore a prescription for 30 Tylenol 3s and 14 Valium.
“I just told the doctor I needed a refill,” he said.
And the original prescription?
“I broke my finger — it hurt.”
That was six years ago.
“My boyfriend taught me how to go in there for pills and say, ‘I have a sore back, I can’t sleep,’” said Tina (not her real name).
“People get hooked on them.
“You get fucking stoned.”
The pills are great if someone’s coming off crack or a needle binge, she added.
Like Sam, Tina was quick to demonstrate how easy it is to get pills.
“I’ll be right back,” said the 26-year-old mom.
Leaving her newborn in the car with support worker Shirley McKay, Tina visited another walk-in clinic.
She emerged five minutes later with a prescription — 30 T3s and 14 Valium.
“I told him I wasn’t breast feeding,” she said.
“He asked me if I wanted 40 or 30 (T3s), but I only got 30.”
The doctor also ripped up a notice stating Tina wasn’t supposed to get Valium.
She overdosed in the past.
“He said, ‘We’re past that now,’” said Tina with a grin.
McKay is one of Fetal Alcohol Syndrome Society Yukon’s outreach workers.
She frequently drives clients downtown, only to learn they’re heading to the clinic.
“They say they’re sick,” she said.
“And I can’t force them not to go.”
Another FASSY outreach worker, who asked to remain anonymous, has seven clients with FASD.
Five of them use the clinics regularly, and three go every week, he said.
“Sometimes they’ll get a prescription at one clinic, then two days later go get the same prescription for T3s and Valium from another clinic.”
“We have a crisis,” said Yukon Medical Association president Rao Tadepalli.
“A small portion of the population who’s addicted is driving the resources dry.”
On duty at Whitehorse hospital emergency, Tadepalli took a few minutes to talk passionately about prescription misuse.
Yukon doctors are very aware of the situation, he said.
“But we are not responsible for cultivating it.”
Drug-hungry patients manipulate doctors, he said.
“And walk-in clinics bear the brunt of this crowd.”
Valium is one of the most common prescriptions Tadepalli writes while working in emergency.
The doctor regularly sees patients exhibiting symptoms of substance abuse.
Many of Tadepalli’s patients drink daily, and when the monthly social assistance cheque runs out they end up in withdrawal, suffering paranoia and seizures.
“I’ve had patients in here with withdrawal so bad we’ve had to tie them down to the bed,” he said.
The clinics are used by drug and alcohol abusers, said Tadepalli.
Those physicians are in a tough spot, he added.
“I’d hate to be in their situation. Nobody wants to be a bad doctor.
“But if a patient complains they’re having alcohol-related seizures, what do you do?
“You give them something.”
And if they’re alcoholics, they can’t have plain Tylenol because it would further damage a liver already battered by drink, he said.
Ibuprofen causes bleeding in the stomach.
“So you give them codeine,” said Tadepalli.
“If they moan and groan and say they’re sore — you don’t turn them away.”
In the Yukon, there’s nowhere they can turn, he added.
Pain is a big part of ongoing drug and alcohol abuse, and managing it is difficult. Especially when there are no adequate treatment facilities or services in the territory, said Tadepalli.
“It’s a hopeless situation.”
The government knows all this, but it’s not a priority, he added.
Prescription drug abuse is a nationwide problem.
“But it’s worst in the Yukon,” he said.
Here, there’s no way to monitor prescriptions, said Yukon Medical Council co-ordinator Dee Balsam.
Responsible for regulating Yukon doctors, the council runs a Triplicate Prescription Program through Alberta’s College of Physicians and Surgeons.
But the program only controls “real opiates,” said Balsam.
Tylenol 3, Valium and Ativan aren’t on its list.
These drugs are prone to abuse, said John Swiniarski, assistant registrar of the Alberta College of Physicians and Surgeons.
“And there are a number of these drugs that we’d like to add to the list,” he said, citing the addictive nature of Valium, Ativan and Tylenol 3s, which contain codeine.
The problem is manpower.
The Triplicate Prescription Program requires three copies of prescriptions written for highly addictive drugs, like morphine.
The doctor and pharmacist each get a copy and a third is mailed to the Alberta college.
Once there, the prescriptions are manually entered into a database that tracks who is taking what, and how often.
“We get about 15,000 of these prescriptions a week,” said Swiniarski.
“And if we added drugs like Tylenol 3s and Ativan to the list, it would, frankly, double our volume.”
The territory needs a system like BC’s PharmaNet, a database that tracks and records all prescriptions, said Tadepalli.
“With a system like this you could at least curb the number of prescriptions and monitor it a little bit.”
By June, Alberta will have a PharmaNet-style information system in place, said Swiniarski. Several other provinces already have this type of system.
Health and Social Services is considering a similar program in the Yukon, said Balsam.
Shopper’s Drug Mart has a database that won’t allow clients to visit its two stores in quick succession to fill matching prescriptions, said Tadepalli.
But other pharmacies in town don’t have systems like that in place.
“You can call the pharmacies and find out one client will have picked up 30 pills here, 30 there and 30 at another,” said Tadepalli.
“So, basically, the patients are breaking the doctors’ trust.”
FASSY executive director Judy Pakozdy argues it’s the doctors, not the patients who are breaking public trust.
“The doctors are the gatekeepers and they should take their job seriously,” she said.
“My concern is not that our clients are ripping off the medical system, it’s that doctors are not prescribing the right meds.
“It’s easy access and there is no control.”
FASSY’s clients are not bad people, said its diagnostic co-ordinator Lilliam Sequeira.
“But when an opportunity like this arises for people with a lot of brain differences, they’re the victims.
“If someone says you can go to a walk-in clinic and get Valium, they just go.”
The doctors don’t do any medical checks, said Sam.
“They don’t ask me nothing.
“These guys are so gullible it’s not even funny.”
See related story on pages 14 and 15.