Pharmacist Amy Lamb has asked council to allow all pharmacies in the city to dispense methadone. (Susan McNeil/paNOW)

By Susan McNeil

Opioid addiction

Methadone access should be expanded, pharmacist tells council

Nov 16, 2022 | 12:00 PM

A pharmacist asked council to reconsider the zoning rules that stop most pharmacies in the city from dispensing methadone.

Amy Lamb, who is also a co-chairperson of the YWCA board, said that patients have the right to access methadone wherever they want and that crime actually drops when patients have more access.

“The rate of violent and nonviolent crimes reduces by one-third if the patient is stabilized on methadone. The annual costs to the health care system for someone who is on methadone is $6,000 versus $45,000 for someone who is untreated,” she said.

Methadone is given to people addicted to opioids to help stabilize their lives and help them stop using illegal forms like heroin or fentanyl, Lamb explained.

When a patient starts the program, they are heavily monitored by the professional dispensing the drug, which can include pharmacists.

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“This is actually something that an individual can seek on their own with a practitioner. There are no longer limitations on the types of prescribers that can prescribe for methadone therapy,” said Lamb.

Once stabilized on methadone, the user is more able to lead a normal life, including finding work and housing.

While all councillors that spoke up were in favour of the drug being available, not all were in favour of having it in places like residential areas.

Mayor Greg Dionne said he supports the continuation of the six pharmacies or dispensing services that exist now, but does not want methadone to be available in smaller areas.

“When I went to buy my house, I looked at my neighbourhood. I wanted a convenience store. I wanted a gas station. I’m happy that we have a pharmacy. I didn’t want a methadone clinic,” Dionne said.

Residents should have a say in the development of their own neighbourhoods, he added.

In 2018, the council amended its zoning bylaw to only allow methadone in certain zonings, and that is what Lamb is seeking to change.

She pointed out to council that they may not have the authority to stop medical professionals from offering their full scope of practice and essentially choosing what services are provided.

That is an angle council wanted to explore more, and at least one councillor concurred that it might be an issue.

“Should we as a council say these are the medical procedures that are in a drug store or in any store? Should we be able to do that? I don’t know. Will we be sued?” asked Dennis Ogrodnick.

The planning department will look into that aspect of the discussion and bring back a report for council to consider.

Dionne also asked how providers know the program is successful and what measurements are used.

“If you say the program is working, then you’ve got to have the data to back it up,” he said.

Many people who end up taking methadone can stay on the drug their entire lives and are never completely free of it.

The answer is not that black and white, and people may need to change how they think of success, responded Lamb.

“Elimination of therapy is not necessarily the ends of addictions recovery,” she said.

Rather, it can be that the addicted person is stabilized and becomes more functional, but still needs the methadone to maintain their stability.

If they are not looking for drugs actively and are not putting the burden of coping on their family or friends, Lamb said that is also a success.

Councillor Blake Edwards, who works at the penitentiary, said he sees the value of the program but also knows there are resulting issues.

“When used properly, methadone and suboxone is a really good program. People function in their day-to-day lives when they can’t when they’re using illegal drugs,” he said.

There is the issue of diversion in which the patient takes the methadone and supplies it to other users.

“Why are methadone and suboxone, continually and maybe not regularly, but still sold illegally after the use? They get it and they sell it. How come,” Edwards asked.

“Usually, to carry them over until they can get their next drugs,” said Lamb.

Steps are taken to prevent diversion.

In the early stages of the program, the consumer is watched while they drink the methadone.

They must provide urine samples that serve two purposes, to make sure the methadone is in their system and that no other drugs are.

As they progress and earn the trust of the dispenser, patients can then be allowed to bring home several days or a week of supply so they don’t need to return to the pharmacy or clinic every day.

The amount they get is to be reduced as time goes on.

Edwards was also reluctant to have it dispensed in residential areas.

“I support the program and maybe there are some areas where it could be closer, but I certainly don’t support it in the middle of a residential area,” he said.

According to the Saskatchewan Methadone Guidelines, a person has a 15 per cent chance of successfully recovering from an opioid addiction without using methadone as part of their treatment.

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susan.mcneil@pattisonmedia.com