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[ Opinion ]

Harm reduction? More like harm inflation.

I recently wrote a blog about my how I understand that in some circumstances harm reduction is necessary. However, as I have more and more exposure to our methadone system, I still think it does more harm than good. The Ontario Addiction Treatment Centres (OATC) is where the majority of addicts who use methadone go to take their daily dose. It was brought in so that people didn’t have to travel long distances to seek methadone treatment. Methadone is used for people wanting to stop using opiates. It’s part of the whole harm reduction model. Good in theory, but in many cases it’s just enabling people to continue with in their addictive behaviours.

Someone who is on methadone must carry out regular urine testing so that doctor prescribing the drug can know if the person is using other substances. If this is the case, there’s a good chance the person may not be suited for the methadone program.

For over 10 years, I’ve worked at various addiction centers where urine testing is a regular part of treatment. The credible centers have “supervised urine tests” to ensure the client is not providing fake urine. I’ve met many people who receive methadone from the OATC and they tell me there is no supervised urine testing. A person can sneak clean urine in and pass the test with ease.

Methadone does not provide freedom from addiction. Granted, people are not seeking out drug dealers or shooting up using dirty needles (those who actually follow the harm reduction program) but they still are tied to the clinic they are associated with as they need that daily methadone drink. I have a client who was all happy because her father plans to take her on vacation to South America. What she hasn’t taken into consideration is that the OATC clinic she goes to isn’t going to give her a few weeks of methadone carries, and if they did, she wouldn’t be able to take them across the border.

Many of the people I come in contact with are using crack, cocaine, marijuana and/or a plethora of other substances on top of their daily methadone dose. These people tell me, they are providing fake urine to the OATC so that they can continue to abuse the system. What is happening is that their addictions become worse and they don’t have to face the consequences of their actions. The majority of these clients are on Ontario Works so the good old taxpayer is footing the bill for the methadone. This is not harm reduction—it’s harm inflation, and no one benefits. In my opinion, a better system would be to provide methadone with a goal towards abstinence. This would be more beneficial, health wise, to the client, and financial wise, to the taxpayer. Maybe the province needs to look at paying for Suboxone which is a much better tool to help an opiate addict achieve abstinence.

Until the province stops basing addiction strategies on pie-in-the-sky thinking and begins taking a more reality-centred approach the harm in harm-reduction will only become worse.