At the end of October, the only pharmacy in Clarenville that provides the opiate dependency treatment program, also known as the methadone program, will cease to dispense the drug.
For individuals who rely on the treatment, like David, they are now left with nowhere to turn.
“Without the medication, I can’t function. The pain just causes my body to go into spasms in my back. And the more pain I’ve got, the worse the spasms get,” said David in an interview with The Packet.
The pain in his back — the result of a back injury from 2005 — has also caused sciatica (numbness) in one of his legs.
Following the injury to his back, a soft-tissue injury not repairable by surgery, David’s doctor prescribed him painkillers for the injury.
He said as his body got used to the medication, it became less effective.
By 2008, he said he was craving more medication to ease the pain. He said the pain would begin again before it was time to take his next prescribed pill.
“I started wanting more,” he said. “It was pretty manageable at the time. I kept telling myself I could handle it.”
Desperate for pain relief, he sought out meds elsewhere.
“I ended up going to the streets looking for the drugs,” he said.
And that created more problems. The drug use affected his family. David said by 2010, his addiction really got out of control.
“I almost lost my family,” he said. He knew he had to find another option.
In 2011, he decided to seek out methadone treatment. Methadone is used to wean people with opiate dependencies off the drugs.
However, the wait list for the provincial methadone treatment program was about a year long. He moved away to Ontario for about six months before he was approved for the methadone program in Newfoundland.
David depends on methadone for a normal life. Without a daily dose, he said his physical health, as well as his emotional and family health, could be at risk.
And in just eight weeks — after Oct. 31 — David, along with about 14 other people in the program, won’t be able to get methadone in Clarenville.
“Oct. 31, I’m going to go in there and get my last dose. After that I have no options; either move to St. John’s or go back on the pills,” he said.
And moving to St. John’s is not an option. Both he and his wife work in Clarenville, so they are financially tied to this town.
“I’m terrified,” he said, referring to the thought of not being able to get methadone. For the 38-year-old, methadone has been a saviour. The drug works to combat his back pain and control cravings for other pain medications. He said it doesn’t work for everyone, but it certainly works for him.
“I highly doubt I’m going to be able to manage (going back on pills),” he said.
Methadone, he said, helped his physical condition and saved his marriage.
“I have a regular life, now,” he said. “We have another child, and everything is back to normal.”
David said he filed a complaint with government, but he hasn’t heard a word on whether anyone will do anything to ensure methadone is available in Clarenville, or other rural areas, for people like himself who need it.
He warns that if methadone is not available locally, there could be serious repercussions.
“From my experience with people in the program, I believe the public should be very worried. There will be an increase in crime, as some people will do anything to stop the withdrawal symptoms.”
Sean Funk is the owner and managing pharmacist of the Medicine Shoppe, the pharmacy that has dispensed methadone for the Clarenville area for almost 10 years.
Funk said he has decided to stop providing the methadone program because of his perceived changes in the Newfoundland and Labrador Pharmacy Board’s legislation, effective Dec. 1.
Funk has a problem with the changes in “carry doses” for outpatients in the program. Carry doses refer to patients being able to take their prescribed dose out of the pharmacy and take the drug without the supervision that is normally required. Patients have to earn carry doses over time spent in the program.
“(Carry doses) are not usually granted to a new patient until about three months into the program,” Funk said. “You have to earn each carry dose by testing clean and staying off any contraband medication.”
The Newfoundland and Labrador Pharmacy Board states there are no real changes to the carry dose procedure, but the guidelines have been restated to make it more clear what is to be expected of pharmacists who dispense methadone.
The Medicine Shoppe is only open six days a week, so if a patient does not have a carry dose, Funk is required to accommodate the patient on his day off when the pharmacy is closed.
“I’m a single pharmacist only pharmacy and only open officially six days out of seven,” Funk said.
In situations when a pharmacy is closed, Funk said they are supposed to make arrangements with other pharmacies or the local hospital to provide methadone for their patients. This is not possible as the Medicine Shoppe is the only pharmacy that provides methadone in the area.
Shoppers Drug Mart does provide a methadone program, however, it is only contracted to provide service to the inmates of the Correctional Centre for Women.
A pharmacist can also get a doctor to award patients with carry doses who haven’t otherwise qualified, but often this is not an option as dealing with narcotics prescriptions can be a high-risk process.
Up until now, Funk has been seeing methadone patients on his day off on a completely voluntary basis.
“If you resort to that option, you’re not open six days a week, technically you’re open seven days a week and you get no days off whatsoever,” he said.
“That option becoming the responsibility of the pharmacist in charge … as of Dec. 1, with the new regulations, rather than voluntary as it has been in the past, is an option that I cannot submit to because it robs me completely of any kind of time off.”
He said his personal time has already been interfered with over the years because of patients in the program.
While recognizing not all patients behave the same way, he said he’s had people come to his home, call him after missing appointments and try to get the drug without having attended the required doctor’s appointment.
He’s even had fights in the pharmacy and threats of physical violence towards himself.
“I’m not meaning to tar everyone with the same brush,” said Funk. “Some of them are quite reasonable and normal folk. But there is a percentage of patients who are belligerent towards the rules … I can’t offer a service where I’m the only pharmacist and the way things have gone the last few years, I can’t afford to hire another pharmacist in terms of the current business practice that I’m doing.
“The only option that is left to me is to discontinue.”
Funk said he has given his patients adequate notice to make other arrangements if possible. He said for certain patients who have a maximum of six carry doses per week, it will require a once a week visit to Gander or St. John’s.
But not all patients are entitled to that many carry doses.
“It was a tough decision to make (to discontinue) because the revenue is not insignificant. But I can’t be a prisoner to my pharmacy seven days a week, 365 days a year,” Funk said.
He doesn’t know what will happen to the patients after Dec. 1.
“I haven’t been approached by anybody for any kind of way out or compromise to this problem. As far as I know, no one else (in the community) seems willing to take up the torch.”
The Packet contacted the Department of Health for information regarding the future of the methadone program in Clarenville, but did not receive a reply by deadline.