1. Methadone ? Methadone and Treatment By: Eleu Pontes CSW

2. Methadone is the most highly regulated and controlled area in addiction treatment, and also one of the most highly regulated in all medicine. In the eyes of the public, policy makers, as well as health and social service providers, there is an unfortunate stigma associated with methadone and people who receive Methadone Maintenance Treatment (MMT).

3. Brief History of Methadone Hitler is cut of his Morphine supply. First patented in 1947 under the name Dolophine. Late 1950’s through the 1960’s: Doctor and Researcher Dr. R.Halliday. Early 1960’s The New York Research, By: Dr. M.Nyswander and Dr. V.Dole.

4. World War II and Va10820

5. 1947 Eli Lilly Pharmaceutical patient Va10820 under the name Dolorphine in the US Dolorphine The Dolor is the Latin word for Pain The word Finis or Phine is the Latin word for End Dolor/ Phine or Pain/ End Or End of Pain

6. Dr. Robert. Halliday In 1959 to early 1960’s Opened the first ever MMTP in the world in downtown East-side of Vancouver. Dr.Halliday once say Methadone is to the Addict as Insulin to the Diabetic.

7. Dr Vincent.P.Dole,MD.

8. Canadian History of MMT Narcotic Control Act 1972 assigned Narcotic prescribing (specifically methadone) to the Federal Government 1972 Approx. 24 MMT clients in Canada 1975 due to NCA there was a 33%  in clients in treatment 1985 further reductions in treatment (only 1/3 rd of the 1972 numbers were still in treatment) 1995 BC is granted Provincial control over methadone prescribing & dispensing Ontario followed closely behind. 1996 Ontario– 700 clients 2000 Ontario --5,961 clients 2007 Ontario-16,406 Estimated 1,000 new clients enter treatment each year in Ontario. The College of Physicians and Surgeons of Ontario

9. Who’s doing what for MMT ? The number of Physicians holding exemption in Ontario to prescribe Methadone is 258 as of 2007 228 hold 3 year exemptions 30 hold 1 year exemptions Ontario has about 10,000 Pharmacies. 3,059 are dispensing Methadone as of 2007. 358 are presenting accepting new clients as of 2007.

10. The Opium Poppy Plant

11. Opium Historical records show the use of Opium as far back as the 3 rd Century BC. The word “Opium” comes from the ancient Greek word “JUICE”

12. The invention and availability of the Hypodermic Needle.

13. What is an Opiate ?  A term refers to drugs deriving from the Opium Poppy Plant.  Drugs like: Opium, Morphine, Codeine and others..

14. What are Opioids ? It’s a family name. These are synthetic drugs. Drugs like Demerol, Dilaudid, Oxycodone, Methadone, and many more. It has been estimated 80,000 regular illegal opioid users in Canada Centre of Addiction and Mental Health 2003.

15. What is Methadone ? It is a synthetic opioid. It is a slow releasing synthetic opioid. It is taken orally. It is mix with an orange tang mix. It begins to take affect within 30mins. Peak level within 4hrs. It effect can last for 24 to 36 hrs. Tolerance. A 40 t0 60 mgs of Methadone can be lethal to non-tolerant adult.

16. How MMT Program works ? In the beginning your first visit (3 day waiting period). Urine samples and/or Lab tests. Number of weekly visits. Visit to Pharmacy and Carries. How to achieve carries. Lock box.

17. Urine Samples (drug testing)

18. The benefits of MMT. An effective treatment for opioids dependence. Helps prevent the transmission of HIV/AIDS and Hepatitis C Viruses. Helps reduce Criminal Activities. It has reduced the number of Deaths due to Overdosing. Improves Economic Productivity. It improves Physical and the Mental Health of the individuals. Improves both the quality of life and outcome of pregnancies.

19. MMT is Cost effective Every $1 spend on Methadone Maintenance Offers a cost belief of $4 to $13 Stoller & Bigelow, 1990 (USA) CALDATA study

20. MMT is cost effective Ontario Stats Estimate of total annual costs related to opioid addiction in Ontario = $660 million. Estimate of total annual cost to supply MMT all of the above = $9 million Based on very conservative estimate of 15,000 individuals.

21. Tapering The one person to offer support is their Physician. The lack of Counseling, Therapist, and/or Social Worker. Cases of positive tapering are few. Clients feel they need to rush throw doctor appointments.

22. Methadone Maintenance treatment. MMT does not cure opioid dependence: rather, it is a medical treatment that can help people manage their opiate addiction and stabilize their lives. It is not appropriate for everyone who is opioid dependent, and is only one of a number of treatment option that should be considered. When MMT is used appropriately however, it can be live-saving treatment. Methadone Maintenance Treatment Practices Task Force. W.Anton Hart.