Methadone Clinic Meeting

Most of you will be aware of the buzz around methadone clinics over the past two years.  For a period of around 18 months we have been in the process in London of creating a by-law to manage methadone clinics and pharmacies.  With the by-law now completed and being law, the first organization is applying to open a new clinic.  One of the components of the new by-law is a public participation meeting around site planning.  When the by-law was being developed I expressed some concern around this stipulation, as I wondered whether it might just bring out the worst in terms of NIMBYism.  Sure enough, comments on this and this article in the London Free Press confirm my concerns.

An important first place to start with the methadone discussion is a reminder that methadone is a treatment modality for addiction.  Many decry methadone stating instead that we should be treating the addiction, which shows a degree of confusion.  Methadone has been amazing as with no other substances do we have the opportunity of giving people medicine to eliminate addictive cravings, though researchers have certainly tried.  Methadone does not get an addict high (though it would someone who has never taken narcotics), so people who work in a factory or operate heavy equipment are able to work when they have taken their dose.

For community members concerns, I believe the most important comment in terms of methadone being a treatment is that it alleviates a huge amount of crime.  If someone is unemployed and supporting a $150/day addiction, they are likely involved in property crime (ie. theft), prostitution, or drug dealing to support their habit.  By giving them a medicine that blocks the cravings this is a huge boon to the community.  Imagine the 1300 or so people currently receiving methadone treatment not having that option, and still having their addiction.

It is also worth noting that narcotic addiction shows no preference based on class or neighbourhood.  The people accessing methadone maintenance treatment are our neighbours, our relatives, our co-workers, and our friends.  They want their treatment to be private and accessible.  This is quite relevant to the current discussion of the site on Whancliffe Rd (pictured above), as my fellow residents of Old South at times forget that health and social problems exist in our neighbourhood like any other.

Which all ties in nicely with the particular concern around this site, that there is already another clinic a few blocks up the street.  The first point I would make is that no one knew that other clinic was there until it was publicized, not even myself, who has worked in the sector and drives by it almost every day.  We need to recall that the initial purpose of creating the by-law as to ensure that we had a lot of small clinics, instead of a couple of large ones.  This is exactly what is being proposed.  The applicant has done their analysis and found that the market is demanding another site in the area, the current small, quiet one being insufficient.  So, a second small, quiet site nearby will meet the demand in a way the least impacts upon the community.

If you would like to have your say on the issue, I invite you to the public participation meeting on Wednesday, September 5th, 2012 from 6:30 to 9:30 p.m. at Hillside Church located at 250 Commissioners Road East (at Wortley Road).  More details are available on the OSCO website.  These meetings are all about making our democracy participatory, so are a great experience and I would encourage you to both come out and speak out.

15 thoughts on “Methadone Clinic Meeting

  1. Good points. As someone who has worked in the addictions field–a long time ago–I think methadone is great. It makes recovering addicts functional and shows they want to get clean and become productive.

    Think of methadone as another prescription drug. If pharmacies can give out tranquilizers and other potentially harmful drugs, why not methadone.

  2. Could not agree more Abe. The inflammatory coverage by the local press has been very disappointing. The new guidelines make a lot of sense and most people living in this area, including myself, did not even know the other clinic was there. To me this means that they are doing this right and have earned the benefit of the doubt for locating and running another clinic. See you all at the meeting.

    • I appreciate the insight. People have misconceptions in regards to what methadone treatment is really about. I hope that those that come to the meeting are open minded and understanding about the situation. I for one am willing to support those who are trying to get their lives back on track, if this clinic will help people overcome their addictions I see no problems in helping them to once again become contributing members of society.

    • With all due respect to Mr. Brown (and I consider him a friend), I would suggest that there is an simple and obvious reason why the impacts of the two or three pre-existing methadone dispensaries in his neighbourhood are so low as to not even have merited his notice: the pharmacies do not derive the bulk of their income from the dispensing of methadone. So long as a pharmacy derives only a portion of its income from methadone dispensing, the operation will take all of the necessary steps to ensure that anti-social behaviour and loitering does not occur on or near the premises. The reason is obvious: it will affect the pharmacy’s bottom line.

      A methadone clinic, for sure, and perhaps even a dispensary with an overly large methadone dispensing clientele, does not have the same business constraints placed upon it. The operator of the clinic at 528 Dundas is infamous (in my mind, at least) for stating, on several occasions, that what happened on the street after his clients left the clinic wasn’t his problem.

      So, to me, the question isn’t about whether we should allow methadone treatment programs to be dispersed across the city or not, or even where they should be located, but what controls we can put in place to ensure that the operators of these facilities are fully engaged in limiting the anti-social behaviours from what are, for sure, a limited number of their clients and associated hangers-on.

      But this is largely beyond the powers of the municipality, and vetting owner/operators of clinics and pharmacies during the approval process is outside of the function of a planning application in any event.

      If even half of the operational deficiencies of Ontario Addiction Treatment Centres (OATC – the owner of the Wharncliffe methadone clinic) detailed in various media over the last several years are true, then those residents living in the vicinity of the new clinic have a right to be concerned.

      In my view, OATC is the Archer Daniels Midland of the methadone industry, factory farming the misery of our drug-dependent brothers and sisters.

      • Thanks Greg, for bringing a measure of common-sense to the debate. As a former “Old-East” resident, with several fond memories of your concerted efforts to build community spirit, I can also say that both the appearance and “factory farming of misery” that occurred outside 528 Dundas was of diminishing value to the neighborhood, and did little to serve anything but the most basic need of the people who were served by that dispensary. As few as three years ago when I lived there, there was not room to walk on the sidewalk, and the stench of urine was overwhelming. I am wondering how it is that community members speaking out in advocacy for better conditions are suddenly the “NIMBYS” who disappoint Abe, and yet the corporations that allow this human trafficking for profit are given the “well they don’t have a great track record, but..” excuse.

        Are we to believe that these people who live in cushioned surroundings in their rather exclusive “Old South” enclave are not, deeply at heart, the most NIMBY of all? The Wharncliffe Road corridor is, although it may fall within the boundaries of, NOT Old South. It is a commercial corridor. I propose that we situate any future methadone clinic in the London Normal School, essentially closer to the true “Old South” than some commercial corridor that is included in the same jurisdiction, but far enough away from the patrons of the shops of Wortley Village.

        These people have the intellectual arrogance to call everyone else NIMBY, but most go home to their safe neighborhoods, far removed from anything that resembles 528 Dundas. I’ve always been a bit tired of people who live in Old South, and propose to locate all social services either in the core or to the East a bit, but never on Wortley Road. I firmly believe that if you care deeply about a certain population and a cause, you will live among them. I’ve always loved Old East, with the real people.

        Abe, there are many questions that you ask, and a lot of criticisms leveled at almost every party, but with an absolute lack of ANY clarity in terms of actual modifications to the plan. (@4:33) It diminishes any credibility to discuss at large rumors and what someone else could do to find out whether rumors are true. Use your time to get solid answers and approach the community with:
        A. Actual data, not rumored hearsay
        B. A REAL, deliverable, with measurable results, not just criticisms hurled down from your ivory tower.

        Also, Abe, I think that you should move out of your enclave and live with the real people in Old East. I think I know of a realtor *see above* who can help you find a very nice home steps away from 528 Dundas Street.

        • Ben, isn’t that a bit harsh? This wasn’t a written academic report requiring actual data and concrete solutions, but rather an opinion piece posted on a personal blog. I don’t believe that posting one’s thoughts in response to a community meeting warrants such harsh personal criticism really does it? Abe works tirelessly to advocate for, and bring attention to the needs, rights and injustices of residents who are homeless, many of whom struggle with mental illness and drug addiction. I think it’s unfair to suggest that because he doesn’t physically live directly among the population, that he doesn’t care deeply about them. He most certainly does. He has spent a great deal of time working with this population, at street level and beyond. He does not sit perched upon an “ivory tower” simply hurling criticisms at others as you suggest. I admire the work Abe does, and I for one am grateful that he does this work in our city. We are lucky to have him, and I wish there were more like him.

          • Cheryl, I guess that I don’t think it is too harsh at all. I anticipate that someone with Abe’s level of education, combined with his level of commitment to the cause of addiction and homelessness would have already done some pretty simple research about whether or not other dispensing services were still accepting patients, instead of wasting time discussing various tangental possible truths. I guess if it had been my video podcast, I’d already have made the phone call and provided a ten-second rebuttal, but that’s just my stupid “get-it-done” mentality getting in the way. Frankly, this isn’t just an opinion piece on a personal blog. If you constantly promote yourself as the go-to person for hot topics such as homelessness and addictions, then any posts you make on said blog should probably be useful, factual and actionable, and ultimately support your cause.

            The world is full of armchair socialists, and I would really admire someone who would be daring enough to live within close proximity to the people that they care about so passionately, specifically if that meant leaving a comfortable environment for one that was similar to that experienced by your target population. I simply think that it makes so much more sense for someone as involved in a certain community, as is Abe, to live and work as close to them as possible. We found Old East to be welcoming, engaging and with a much more diverse set of people than Old South. My point is, quite simply, that it appears disingenuous when people who live in mildly- ostentatious, “safe” neighborhoods, (such as a Wortley Road address) imply that community members who are opposed to their own neighborhoods being turned into long lines of human suffering are NIMBYs. This is the crux of my issue. The MMT program location in question on Wharncliffe Rd. is such a distance from the safety of Wortley Village that it renders the “welcoming this in my own community” argument null.

            It is refreshing to see that Mr Thompson was willing to add to the discussion, even if his views didn’t match the usual undulating waves of praise. I respect Mr Thompson, both for his quiet, non-impresario commitment to his community, as well as his actions which bring about positive change, and wanted to add my voice in support of what he was saying.

            I am astounded that Abe would give the OATC an offhand “get out of jail free” card, and yet take such a critical stance against community members who wish to avoid the 528 Dundas situation – where Dr. Judson is said to engage in practices which Scott Burns Planning Consultants states “does not completely follow the best practices recommendations described …by the Provincial Task Force.”

            Lastly, for those of us who have lived most of our lives with relatives who deeply addicted to illicit drugs, it does seem a bit “Ivory Tower”ish for Abe to discuss how he has a relative who may have a bit of a problem with alcohol, thus implying that he is “street to the game”. I realize that Abe has an incredible wealth of knowledge, specifically relating to addiction, that many of us will never possess, but many of us have close relatives who are addicted to illicit drugs, and have a very different learned-experience than his own. Perhaps I was the only one who shook my head in bewilderment at this and many other seemingly-overreaching public policy posts, and decided not to drink the Kool-Aid this time.

  3. I would be willing to wager that many of those who oppose these clinics in ‘their’ neighborhoods have at least one alcoholic in their circle of loved family or friends. Because alcohol is a legal substance we see it play out in society in different ways. But this is an addiction as well, though simply more socially acceptable. Would those who oppose methadone clinics being anywhere near them want to see their alcoholic co-workers, family and friends ostracized in the same ways?

    How hard are our hearts that we despise those who are struggling to dig their way out of a very difficult situation? Evidently very hard indeed.

    There is ample research showing that some people are strongly hardwired to be predisposed to addictions. It is ridiculous to say that anyone chooses to become addicted. Mood altering substances are glorified in our culture, and out of every group of the countless people who use such substances some will become addicted. Those of us who don’t become addicted are often simply lucky.

    I would rather live next to a methadone clinic than to people who are more concerned about their property values than the lives of suffering people. In my experience the people who speak the way the Methadone Clinic Nimby people talk generally make poor neighbours. They tend not to be the ones who help a crying child who has fallen, or reach out to an elderly shut in. They tend to be the people overly obsessed with their lawns.

    I wish that there was a medical method for treating selfishness and hard-heartedness. If we could discover that remedy then maybe we would really have better communities.

    • With all due respect to Ms. Van Linden (and a great deal of respect is due to her for her stellar work in a number of important causes in our city), her sentiment that “I would rather live next to a methadone clinic than to people who are more concerned about their property values than the lives of suffering people. In my experience the people who speak the way the Methadone Clinic Nimby people talk generally make poor neighbours” would carry much more weight with me if she didn’t lead a nice quiet suburban life on a nice shady street in a nice middle-class suburban neighbourhood several backyards away from the nearest arterial street. In her current situation, she has zero chance of having to actually “walk the walk”.

  4. I’m posting this here as it appears we’ve reached our conversation limit in the discussion thread above. 🙂

    Ben, thank you for your reply. I too appreciate other points of view, including yours and Mr. Thompson’s, so I thank you for the discussion. I understand and appreciate some of your frustration as well within the argument. I do see your point about the overall non-actionable feel of the post, but I guess I don’t see it as deserving of such heavy personal criticism. For the most part, because I have seen Abe provide more factual and actionable conversation many other times, it didn’t strike me in the same way it obviously did you. It was less polished – yes, and had more of an immediate, “thinking as I speak” feel to it, but I simply accepted it in that vein.

    I admire people for their work, regardless of where they live, if they are dedicated to their particular cause and work hard toward making change, which Abe does in my opinion. I would never call him an “armchair socialist” simply because of where he lives because I know he is deeply committed to his work and to the people it directly affects. I agree that there are indeed many armchair socialists who are little more than talking heads, Abe isn’t one of them. At least I’ll be prepared to accept that you’ll likely call me the same when I begin my work in social services in the very near future if I don’t pack up and move into another population-specific neighbourhood or community immediately. So be it.

    I too am one of those people who has lived most of her life with immediate and extended family members struggling with very serious addictions as you know Ben, one of whom died recently as a result of this addiction, and another who has benefited from regular methadone treatment dispensed here in London. And yet, oddly enough in direct opposition to your opinion, I don’t see Abe as sitting on his “ivory tower”. Interesting. In fact, I see Abe as someone who is trying to make change so that more families in this city will be better supported in their addictions and hopefully much less stigmatized. I guess overall I’m much more about supporting and respecting those who make efforts to make positive social change in whatever way they can, instead of tearing them apart for not doing things exactly the way I would do them.

    • Thank you for your kind words, Cheryl. It’s always the compliments that make me feel more inadequate than than the insults and insinuations. When people say nice things I feel like I’m moments away from letting everyone down, which I obviously did for Ben in these posts.

      Ben, in terms of discrediting my perspective, I think you were close, but I would offer an even better argument. I don’t think where someone lives or how addicted their relatives are will hold much water, so a better question would be how much time I actually spend with people experiencing homelessness? Because, the truth is, not much. It’s probably been about a week and a half since I last talked to a person experiencing homelessness. Yet, over that week and a half, I have talked a lot about homelessness.

      This was a difficult choice I had to make, because when I started full-time on faculty it was clear that I could not do it all. I loved my work at InterCommunity Health, but could not manage both jobs plus my research and community work. So, I looked at my skills, I looked at my interests, and I looked at how to best create the change I want to see. My strengths lie in policy, advocacy, coordination, education, and these are the ways that I think I can have the most impact. My brother disagrees. He sees the most impact in front-line work, and that’s where he spends his time. Perhaps neither of us are right (or wrong), but it’s good that there are 2 of us (and thousands more) so that I don’t have to try to do it all.

      Does that mean I wasn’t a good nurse, or that I didn’t enjoy helping 20 people a day? Not at all, but you have to make these tough choices. Does this discredit my work? Some would say ‘yes’, some would say ‘no’. I see my responsibility as to do the best work I can, to try to create change, but recognize it won’t be for everyone. I never mean to offend, and am sorry that I have. I always appreciate your comments, they push my thinking, but if my work is just making you mad, life is too short, just avoid it.

      • Abe, no need to worry, I am not offended or angry. I think I was expecting more of a well-rounded discussion than discrediting the naysayers as NIMBYs. I feel that there are valid concerns for privacy, safety and public health that are obvious in what many local community members consider the failure that is 528 Dundas and the adjoining coffee shop. For those of us who have family members who would likely end up receiving treatment at one of these locations, this conversation provides little assurance that our loved ones won’t be lined up like animals in front of traffic on a busy corridor, and it seems that the conversation is very one-sided. It is frustrating when people whose backyards have rose gardens, swing sets and pools instead of used syringes and condoms call the latter NIMBY. Congratulations on achieving full-time status at UWO, I am sure that your students will benefit from your in-depth knowledge regarding homelessness and addiction.

        • I also tried Dr. Cernovsky’s office, who is the other clinic located in the area, and there has never been anyone answer and you get a weird auto voicemail. My hope is city staff can leverage their position to get answers I haven’t been able to get.

          • Just for the record, I don’t think “front-line work” is much (or any?) more effective than the trajectory you have chosen to pursue, Abe. I think the more effective route is participation in grassroots community empowerment, conscientization, and mobilization. Front-line work within social service agencies is generally a very very different thing than this.

  5. It is understood why many do not consider methadone treatment as an appropriate way of treating addicts. However, instead of simply showing a negative attitude towards methadone, people should try and understand how methadone actually functions, what the treatment is all about.

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