A new clinic is facing backlash for harm-reduction methods
The community of Bloordale, a small village stretching from Lansdowne Ave. to Dufferin St. just around Bloor St., has recently seen the addition of a methadone clinic. Whether it is welcome or not has been a part of a heated debate for many weeks within the community.
“It takes a long time to build a sense of community, where neighbours will talk to each other,” a local resident said on the topic of the new clinic. “That process of community-building, though, is not completed yet…and I think the gains that have been made in the last eight years could be at risk, and that the community could slip back into its waves of problems.
The clinic, run by five doctors, opened its doors on November 10th, moving from its location in Parkdale-High Park to its new locale at 1290 Bloor St. Just after the clinic opened to the public, Bloordale residents were invited to a meeting scheduled for November 13th in order to express their concerns.
MPP Cristina Martins mediated the panel, which was held at the Wallace-Emerson Community Centre. Along with Martins were Councillor Ana Bailao of Ward 18, a constable from Toronto Police 11 Division, representatives from the Centre for Addiction and Mental Health (CAMH), and the doctors of this newly situated clinic.
Martins, who hoped the panel would provide an “educational session” on the topic of Methadone Maintenance Treatment (MMT), opened the meeting with a few words about the evident stigma that plagues issues of drug dependency. “Sometimes when people think about MMT, they have a vision of what that person looks like,” she said. However, this hypothetical person is “classless,” and can be almost anyone.
“Yes, it can be that person who is addicted to an opioid, to heroin, it can also mean—and it often does mean—the person who is addicted to a painkiller.”
Opioids are drugs that reduce the pain in a person. They can range from over-the-counter pain medication, to morphine used in hospitals, to “harder” drugs such as heroin. Methadone is a synthetic opioid, which, in medical settings, is used to ease and even prevent opioid withdrawal. It should be noted, however, that, as per the CAMH methadone guide, methadone is only part of a larger treatment of drug abuse and not a cure in and of itself.
Dr. Andriy Samokhvalov, a clinician at CAMH present at the meeting, offered more details on what methadone is, saying it does not give the individual a high, and that when one is on methadone they do not have to take any other type of opioid. “This program usually provides people with a quite organized, structured treatment, [allows them] to add structure to their lives,” he said.
With the reduction of risky needle usage and with added structure to people’s lives, MMT can, the doctors assured, reduce the risk and spread of infectious diseases such as HIV.
Fears persisted, however, as was noticeable once the floor opened to some unhappy residents. The most prevalent fear was what this clinic might do to the safety and security of the community, a community that has been worked upon and strengthened over the past couple decades.
One resident brought up the example of the methadone clinic at Dufferin St. and St. Clair Ave. W., which has suffered backlash in the recent years. The people of St. Clair have claimed to feel uneasy when out in the neighbourhood due the drug users that surround the clinic, a Toronto Star article reported back in 2012. A local McDonald’s even installed needle depository boxes so as not to have used needles in the immediate environment.
Stephanie Venneri, an Addiction Therapist with the Toronto Opiate Support Team (TOST), attended the meeting, and explained that there were factors missing in the Dufferin and St. Clair area that have contributed to that unease. “It is a very different experience in that neighbourhood and a very different experience at that clinic,” Venerri commented. “Let’s not assume that the problems in that neighbourhood are because of that clinic. There are a lot of problems in that neighbourhood. There are not a lot of services—there’s absolutely no services for people who use drugs or who have mental health issues along that strip, so that’s why I think it congregates in that area.”
These kinds of services can start at the clinic. Dr. Angelo Stamadianos, one of the doctors of the new clinic and one of the doctors present in the panel, commented on the steps he takes to better the lives of the people that visit him. “I pride myself in establishing a non-judgmental practice, mutual respect for the patients and building on a relationship to foster growth in the individual to better their lives.” Although not a formal mental health service, this type of bonding can reduce the fears some people may have when seeking treatment.
Although the community’s fears have put the clinic’s status as a methadone dispenser into focus, the clinic will act as a regular pharmacy, dispensing medications for things like heart disease and diabetes. Councillor Bailao stated that Bloordale was zoned for a medical clinic, and since MMT is allowed in Canada, the methadone detail passed without legal review.
“At the city we don’t regulate. This is just like a family clinic and that’s why, for example, my office wasn’t notified,” Bailao said. “The city has no say. The area is zoned for a family clinic so they can open a family clinic.”
Individuals who have attended the meeting noted that other clinics in the area have not dealt with this kind of commotion. Jill Parsons, a Registered Midwife of the Midwives Collective of Toronto, has commented on the lack of public shock when the Collective moved into 1203 Bloor St. W. “Nobody had any issue with our clinic when it opened up,” Parsons said.
However, a midwife clinic is different than a clinic that dispenses methadone. The latter serves those who are struggling with drug addictions and may have mental health issues. But as Jenna Robertson, a Registered Midwife of the Association of Ontario Midwives, pointed out, midwife clinics may need to provide the same services as a methadone clinic. Both types of clinics attend to adults, and “midwives meet people who struggle with depression and addiction,” she stated.
The worries of the Bloordale residents may be legitimate, though not all community members share them. The news of a methadone clinic even came as a surprise to some. “I didn’t know there was one,” Kim, a local resident not at the meeting, has said. When asked if the clinic is bothersome and poses a threat to the neighbourhood she replied, “I’ve been living here for 20 years. It’s going to be better than it was before. People need to go somewhere, and at least they will be on methadone and taking control of their lives.”
One such example of someone taking control of their life by way of MMT is Bryan, a former resident of Toronto who once suffered from intravenous drug use from the age of 18. “I left home at 13 years of age because of family of origin issues, and drugs were my means to cope with the pain,” he said. “I yearned to be free of the pain my drug addiction brought, but could not cope with the withdrawal symptoms associated with opiate addiction.”
Due to this addiction, that Bryan terms as a “mental, physical and spiritual malady,” has plagued his life in quite a few ways. “My addiction caused me to contract HIV at age 23 and suffer a heart attack at age 29.”
At this age, Bryan was offered a chance to change his life. MMT had been offered to him at CAMH, where he had to undergo a drug test, answer a few questions about his addiction, and visit a therapist before being put on methadone.
Dr. Stamadianos, who attended the meeting on November 13, was only the third methadone dispenser Bryan had visited, though he found him to be one of the best. “He treated me with dignity and made me feel as though I truly did have worth, which eventually afforded me the ability and strength to move forward with my life drug-free.”
When asked if methadone is merely another opiate people can become dependent on, Bryan answered that he was under the supervision and care of doctors, and, after close to 12 years and a 12 step program, was able to wean himself off of methadone.
While the stigma surrounding MMT prevents people from seeking this type of treatment, it does in fact help. As mentioned, MMT can prevent risky behaviours. “Even for the indefinite user it is of benefit as it prevents drug seeking, crime, IV drug sharing (and its related health risks), and allows them to get on with their life,” Dr. Stamadianos explained via email.
Bryan has been drug-free since 2003, and since that time he has earned two degrees and lived in Australia for two years, where he has worked in mental health. He currently resides in Texas, where he is an active member of a recovery program, working with others that are suffering from addiction.
“This program really did change my life, I hope a few bad people don’t ruin what has been incredibly life changing for me. I no longer dwell in the realm of hungry ghosts but thrive in a spiritual realm and know relevance.” ncomments powered by Disqus