An up­hill bat­tle

Jared Evely wit­nessed ob­sta­cles for pa­tients in prov­ince’s methadone pro­gram


Sec­ond in a two-part se­ries Edi­tor’s note: Part I, head­lined “One man’s ad­dic­tion,” was pub­lished in the April 1 print edi­tion of The Com­pass and on our web­site (www.cb­n­com­, gave in­sight into Jared Evely’s ex­pe­ri­ence with drug ad­dic­tion.

Jared Evely is very open about his for­mer drug use and his road to re­cov­ery.

The 27-year-old Vic­to­ria res­i­dent took dif­fer­ent opi­ates — Per­co­cet, Di­lau­did, Oxy­cotin and Heroin — recre­ation­ally over a pe­riod of seven years.

Af­ter mov­ing home from Ed­mon­ton in 2012, Jared sought help from the prov­ince’s methadone pro­gram. It was his first step to re­cov­ery, and he has been “get­ting clean” since.

Jared at­tributes his suc­cess over the past year-and-a-half to the pro­gram.

“The pro­gram had a su­per pos­i­tive im­pact on my life,” Jared told The Com­pass last month. “The first year, ev­ery­thing went as well as it could have. And I’m still not do­ing any drugs.”

A lit­tle about Methadone

Those with opi­oid ad­dic­tions can get into the methadone pro­gram — a pro­gram of­fered at the Opi­oid Treat­ment Cen­tre (OTC) in St. John’s.

“Methadone elim­i­nates opi­oid with­drawal and helps sta­bi­lize the phys­i­cal, men­tal and emo­tional well-be­ing of (some­one in the pro­gram),” Jackie O’Brien, a spokesper­son for East­ern Health, wrote in an email to The Com­pass. “In­di­vid­u­als can re­fer them­selves or be re­ferred by a health pro­fes­sional to the OTC.”

On March 17, there were 61 in­di­vid­u­als on a wait­ing list for the pro­gram.

Methadone is a liq­uid in the opi­ate fam­ily that is pre­scribed, usu­ally once a week, by an au­tho­rized physi­cian and taken once a day in front of a lo­cal phar­ma­cist.

The Cen­tre for Ad­dic­tion and Men­tal Health in On­tario de­scribes methadone as a treat­ment for ad­dic­tion, not a sub­sti­tu­tion — a per­son will not get high tak­ing it. In fact, Jared ex­plained, the treat­ment pre­vents a per­son from feel­ing the high from tak­ing other opi­ates, as well.

To get into the pro­gram, a per­son must go through months of screen­ing, blood tests and pos­si­bly travel long dis­tances.

Not ev­ery­one can get a pre­scrip­tion for methadone, and even fewer can write one.

Ac­cord­ing to the Depart­ment of Health and Com­mu­nity Ser­vices, there are 36 doc­tors in the prov­ince of New­found­land and Labrador who can pre­scribe methadone, but only 15 for opi­ate ad­dic­tion. Each physi­cian must have an ex­emp­tion from Health Canada and com­plete a cer­tifi­cate in opi­oid de­pen­dency within three years of re­ceiv­ing the ex­emp­tion.

Jared at­tends a clinic in Par­adise, a roughly 100 kilo­me­tre drive from his home­town, on Fridays dur­ing the clinic’s few avail­able hours for methadone pa­tients in or­der to re­ceive a pre­scrip­tion. There is no au­tho­rized doc­tor in the Con­cep­tion Bay North area.

He ex­plained he has heard sto­ries from people who hitch­hiked from Stephenville and oth­ers that have been de­nied their weekly pre­scrip­tion be­cause a snow­storm pre­vented them from get­ting to the clinic.

“It is pos­si­ble that if an in­di­vid­ual who re­quired methadone treat­ment lived in a re­gion that did not have a physi­cian pre­scrib­ing (it), then they would have to travel to the near­est physi­cian,” said Blair Medd, spokesper­son from the depart­ment.

Those who don’t make it to the clinic when their pre­scrip­tion is out likely

“The pro­gram had a su­per pos­i­tive im­pact on my life. The first year, ev­ery­thing went as well as it could have. And I’m still not do­ing any drugs.” — Jared Evely

won’t get it filled with­out a phys­i­cal visit to a pre­scrib­ing doc­tor. Those people usu­ally turn back to opi­ates to avoid the with­drawal symp­toms.

There are cur­rently some 1,000 people tak­ing methadone provincewide, but the Col­lege of Physi­cians and Surgeons of New­found­land and Labrador re­fused to re­lease in­for­ma­tion on the lo­ca­tion of qual­i­fied pre­scribers.

Doc­tor’s vis­its

As part of the pro­gram, par­tic­i­pants are re­quired to give a weekly urine sam­ple be­fore see­ing the doc­tor, al­though Jared said any­one can give a sam­ple for a pa­tient by walk­ing into a hospi­tal with some­one else’s MCP card. A pa­tient can get thrown out of the pro­gram if they test pos­i­tive for opi­ates.

“The doc­tor doesn’t even check for track marks,” Jared said. “He only asks if I’ve given my weekly urine sam­ple, which he has the re­sults on a clip­board in front of him. Then he ver­i­fies my dosage. ‘Mr. Evely, are you still on 70mg?’ Yes. And that’s it. He gives me my pre­scrip­tion and I leave.”

The visit lasts less than two min­utes, Jared said. But af­ter driv­ing an hour into St. John’s, wait­ing two hours to see the doc­tor and an hour driv­ing home, he spends more than four hours get­ting a pre­scrip­tion.

“Dur­ing a typ­i­cal clinic visit, the in­di­vid­ual would meet with their physi­cian to as­sess how they are tol­er­at­ing the methadone dose as well as to dis­cuss any health or psy­choso­cial is­sues,” Jackie O’Brien said. “They may or may not com­plete phys­i­cal ex­am­i­na­tions…”

Some­times a pa­tient will be re­quired to give a urine sam­ple at the clinic. Jared said many males find it un­com­fort­able be­cause, at his clinic, it has to be wit­nessed by a fe­male staff mem­ber.

“I un­der­stand they need to see that you don’t switch the sam­ple,” Jared stated, but noted he doesn’t un­der­stand why a fe­male had to watch the males.

Jared also doesn’t un­der­stand why a pa­tient can’t visit their fam­ily doc­tor for a checkup, and have them re­port the de­tails to the pre­scrib­ing physi­cian for a pre­scrip­tion. He would like to see a com­mu­ni­ca­tion sys­tem that is eas­ier on those try­ing to get help, not pe­nal­iz­ing them for lack of trans­porta­tion.

Of­fi­cials for the depart­ment con­firmed they are look­ing at ways to telecom­mu­ni­cate with pre­scrib­ing physi­cians.

“This ser­vice is (a) new way that could en­hance ac­cess to physi­cians who pro­vide methadone main­te­nance treat­ment,” Blair Medd said.

Where to get help

Al­though there are men­tal health and ad­dic­tions coun­selling of­fices across the prov­ince, Jared be­lieves there is not enough pub­lic in­for­ma­tion for people to get help with drug de­pen­den­cies.

He re­ceived help from his fam­ily doc­tor, but not ev­ery­one has that op­tion.

“Hon­estly, I wouldn’t know where to go or who to talk to,” he ex­plained. “There’s no in­for­ma­tion. (The health author­ity) makes it so hard to get on methadone. You have to jump through too many hoops.”

Jared feels lucky he got the help when he did, and said the re­sult of not get­ting the as­sis­tance is one he has seen time and time again.

“Many of my friends have died from drug over­doses,” he said.

Al­though he is sta­ble, Jared doesn’t be­lieve he is any closer to be­ing off the pro­gram.

“I feel like I’m still do­ing drugs,” he stated. “It’s just the more po­lit­i­cally cor­rect way of be­ing a drug ad­dict.

“I feel like I’m go­ing to be on the pro­gram my en­tire life.”

Those look­ing for drug ad­dic­tion as­sis­tance, or for de­tails on the methadone pro­gram, can con­tact a lo­cal men­tal health of­fice by vis­it­ing­tal­health/rha.html.

Photo by Melissa Jenk­ins/the Com­pass

A lo­cal phar­ma­cist from Con­cep­tion Bay North demon­strates the method for mak­ing methadone dosages for pa­tients. The so­lu­tion is in­gested af­ter be­ing mixed with a drink.

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