Abstract
In this commentary, we argue that the use of amendments to bylaws by Ontario cities and municipalities to restrict where and how methadone maintenance treatment (MMT) clinics and pharmacies operate may run counter to efforts to prevent record high rates of opioid-related overdoses. As the province of Ontario seeks to reform the opioid treatment system, it is crucial to understand the structural (e.g., stigma) and treatment system organization factors that drive the actions of municipalities such as those described above. Changes that exacerbate these factors may lead to increased use of bylaws to curtail access at a time when efforts are underway to reduce alarming rates of opioid-related overdose.
Résumé
Dans ce commentaire, nous faisons valoir que l’utilisation par les villes et municipalités de l’Ontario de modifications à leurs règlements administratifs afin de limiter les lieux et les modes d’exploitation des pharmacies et des cliniques de traitement de maintien à la méthadone (TMM) peut aller à l’encontre des efforts de prévention des taux record de surdoses liées aux opioïdes. Comme la province de l’Ontario cherche à réformer son système de traitement des opioïdes, il est essentiel de comprendre les facteurs structurels (p. ex., la stigmatisation) et les facteurs liés à l’organisation du système de traitement qui poussent les municipalités à adopter des mesures comme celles décrites ci-dessus. Les modifications qui exacerbent ces facteurs peuvent entraîner un recours accru aux règlements administratifs pour restreindre l’accès, alors que l’on déploie des efforts pour réduire les taux alarmants de surdoses liées aux opioïdes.
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References
Gomes T, Mamdani MM, Dhalla IA, Cornish S, Paterson JM, Juurlink DN. The burden of premature opioid-related mortality. Addiction 2014;109(9):1482–88. PMID: 25041316. doi: 10.1111/add.12598.
Canadian Centre on Substance Abuse. Prescription Opioids. Canadian Drug Summary. Ottawa, ON: Canadian Centre on Substance Abuse, 2013. Available at: http://nnadaprenewal.ca/wp-content/uploads/2013/03/3-CCSA-Prescription-Opioids-2013-en.pdf (Accessed May 4, 2017).
Fischer B, Kurdyak P, Goldner E, Tyndall M, Rehm J. Treatment of prescription opioid disorders in Canada: Looking at the ‘other epidemic’? Subst Abuse Treat Prev Policy 2016;11:12. PMID: 26952717. doi: 10.1186/ s13011-016-0055-4.
Blackwell T. Critics question methadone usage as patient numbers soar in Canada. National Post 15 March 2016. Available at: http://news.nationalpost.com/news/canada/critics-question-methadone-usage-as-patient-numbers-soar-in-canada (Accessed July 11, 2016).
Urquhart B. New rules proposed for Woodstock methadone clinics. The Brantford Expositor 1 November 2012. Available at: http://www.brantfordexpositor.ca/2012/11/01/new-rules-proposed-for-woodstock-methadone-clinics (Accessed July 18, 2016).
Donachie M. London methadone clinic facing new challenge. Metro 28 August 2013. Available at: http://metronews.ca/news/london/780002/ london-methadone-clinic-facing-new-challenge (Accessed July 19, 2016).
Mackie C. Overdose prevention in London and Middlesex County: Community Naloxone Program. Report to Board of Health, 2014. Available at: https://www.healthunit.com/uploads/2014-05-15-report-034-14.pdf (Accessed July 20, 2016).
Previl S. Windsor seeks public input on re-zoning of methadone clinics, OurBrantford.ca 31 July 2015. Available at: http://www.ourwindsor.ca/news-story/5770445-windsor-seeks-public-input-on-re-zoning-of-methadone-clinics (Accessed July 20, 2016).
CBC News. Methadone clinic restrictions questioned. CBC News 12 April 2011. Available at: http://www.cbc.ca/news/canada/windsor/methadone-clinic-restrictions-questioned-1.1019169 (Accessed July 12, 2016).
Maloney P. College of Physicians and Surgeons of Ontario expresses concern over methadone clinic cameras. London Free Press 29 May 2013. Available at: http://www.lfpress.com/2013/05/29/college-of-physicians-and-surgeons-of-ontario-expresses-concern-over-methadone-clinic-cameras (Accessed July 21, 2016).
CBC News. Windsor methadone clinic zoning restrictions could be thrown out. CBC News 11 August 2015. Available at: http://www.cbc.ca/news/canada/ windsor/windsor-methadone-clinic-zoning-restrictions-could-be-thrown-out-1.3186715 (Accessed July 19, 2016).
McVicar B. Quinte West closes door on meth clinic. The Trentonian 17 May 2011. Available at: http://www.trentonian.ca/2011/05/17/quinte-west-closes-door-on-meth-clinic-2 (Accessed July 12, 2016).
Jean K. Tillsonburg continues to examine methadone clinic issues. The Tillsonburg News 21 June 2013. Available at: http://www.tillsonburgnews.com/2013/06/21/tillsonburg-continues-to-examine-methadone-clinic-issues (Accessed July, 18, 2016).
McVicar B. City could gain flexibility on methadone clinics. The Belleville Intelligencer 3 July 2012. Available at: http://www.intelligencer.ca/2012/07/ 03/city-could-gain-flexibility-on-methadone-clinics (Accessed July 12, 2016).
Hall B. OHRC letter to the city of London regarding by-law number Z-1-122090 regulating methadone clinics and pharmacies. Ontario Human Rights Commission Website. August 22, 2012. Available at: http://www.ohrc.on.ca/en/ohrc-letter-city-london-regarding-law-number-z-1-122090-regulating-methadone-clinics-and-pharmacies (Accessed July 20, 2016).
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Strike, C., Miskovic, M. Zoning out methadone and rising opioid-related deaths in Ontario: Reforms and municipal government actions. Can J Public Health 108, e205–e207 (2017). https://doi.org/10.17269/CJPH.108.5858
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DOI: https://doi.org/10.17269/CJPH.108.5858