As opioid overdoses continue to increase in the area, so do the number of methadone clinics.
The latest one opened Sept. 26 at the busiest intersection in downtown Orillia.
Dr. Robert Cooper moved his clinic from the Downtown Dispensary, at Mississaga and Front streets, to the former Bank of Montreal building – now the Orillia Drug Store – at Mississaga and West streets. The Downtown Dispensary continues to operate as a pharmacy and methadone clinic.
There is currently an Ontario Addiction Treatment Centre (OATC) in Collingwood on First Street, which works with patients addicted to opioids. After intake, the centre aims to have a patient see a doctor within 24 hours, then medication, which can include methadone, is administered. According to the OATC website, their program is methadone/suboxone based and operates on a voluntary harm reduction approach. For more information on OATC and the Collingwood location, click here.
According to Collingwood's director of planning, Nancy Farrer, the town's current zoning bylaw permits medical clinics in the downtown core and along First Street. Medical clinics are also permitted on properties in the vicinity of the Collingwood General and Marine Hospital.
“It’s busy. It’s busy everywhere,” Cooper said. “There’s a reason clinics have opened in pretty much every small town in Ontario. People need help.”
The latest message from police seems to back that up.
“The Orillia detachment of the Ontario Provincial Police is seeing an increase in opioid-related overdoses in the area,” according to a news release issued last week. “The Ontario Provincial Police would like to remind the public that opioids and their derivatives are often used as a mixing agent within other illicit drugs, putting the public at risk.”
Cooper said he knows of at least one overdose death in the area that happened in the past couple of weeks.
The problem “really increased a few years ago with increased availability of fentanyl and carfentanil,” he said.
The Simcoe-Muskoka District Health Unit recently released an opioid strategy action plan, and Mia Brown, a public health nurse, presented the plan to Collingwood council last month (Sept. 10).
According to details included in the action plan, from 2016 to 2017, there was a 70 per cent increase in opioid deaths in Simcoe-Muskoka with 78 recorded cases of death related to opioids in 2017.
The report includes results of a 2018 lived experience strategy that includes information from 89 people, and suggests one of the key problems leading to opioid misuse, addiction and overdose is a lack of treatment for addictions and pain. According to Brown’s presentation, that was identified as an issue by 52 per cent of respondents.
The number of emergency department visits from opioid poisoning in Simcoe County was 414 in 2017. The count for Ontario is 7,804. On a per capita basis, there were 55.8 visits per 100,000 people for all of Ontario, with a much higher concentration of 83.7 visits per 100,000 people in Simcoe County.
The health unit broke those numbers down further within Simcoe and Muskoka, showing the highest number of visits in Barrie (238), then Orillia (71), followed by Midland (44), South Simcoe (31) and Collingwood (30).
The health unit plan identifies five action pillars including one that puts the focus on treatment and clinical practice by increasing awareness of resources for treatments – such as methadone clinics – and improving timely access to addiction treatments throughout the North Simcoe Muskoka Local Health Integration Network.
A third pillar focuses on harm reduction and zeros in on those who are unable to or choose not to stop using psychoactive drugs and opioids. The health unit plan is to increase awareness of strategies to reduce harm for those using illicit and prescription opioids and increase the distribution of naloxone kits, which is an opioid blocker used in the case of an overdose. Collingwood Fire Department received training on administering naloxone earlier this year and the fleet is now equipped with kits.
The health unit has also built a website with information on the action plan and educational resources for preventing opioid misuse or overdose. It also includes an option for anonymously reporting bad reactions to street drugs.
Cooper administers methadone and suboxone at his clinic, stands behind his method of treatment.
“The nature of opioid addiction, in the absence of treatment, becomes a chronic, relapsing illness,” he said. “If we maintain people on a long-acting opiate, they can function.”
The opiate curbs certain symptoms without getting the client high, he said, allowing them to go about their day and better maintain friendships and relationships.
“Abstinence programs are great, but they don’t have a (permanent solution),” Cooper said.
Cooper, who is chair of the Ontario Medical Association’s Section of Addiction Medicine, said his decision to move into the new location, where he treats multiple types of addiction, was due to convenience and space.
“We wanted a bigger, nicer premises to provide better care for people,” he said, noting there is a bigger waiting room, which will encourage clients to wait inside and provide them more privacy. “Given there’s an opioid crisis, we want people to be treated with respect.”
He has watched it become an epidemic since he opened his first clinic in Toronto in 1997.
Cooper had previously worked in a Toronto hospital’s emergency department full-time when his partner took a course on methadone treatment. At that time, there was a two-year backlog of people waiting for it. So, Cooper decided to get into that area of health care, too.
“It was revolutionary at the time,” he said. “The change it provided to people’s lives was invaluable.”
He started his clinic at the Downtown Dispensary in Orillia in the early 2000s and has seen an increase in clients as the opioid crisis has worsened.
It’s important to be in a convenient location because “this is where the people are,” he said.
“We don’t put clinics in places where people don’t need help.”
Cooper doesn’t believe the location of the clinic will lead to a spike in crime in the area.
“Generally, when clinics open, there’s a reduction in crime because people are doing better,” he said. “People have problems everywhere, but it’s not a result of providing treatment for people who need help.”
He invites anyone with concerns to contact him.
More importantly, he said, is his message to addicts: “Come in if you need the help.”
With files from Nathan Taylor
