After 40 years, Prince Rupert user goes clean

He has been a drug addict for 40 years, but after he became a participant in Prince Rupert’s first methadone program.

The opioid substitution program

He has been a drug addict for 40 years, but after he became a participant in Prince Rupert’s first methadone program he has been clean for a year.

“If I use again I’m going to die — guaranteed,” John Davis said, whose name has been changed for the purpose of this article to protect his anonymity.

The opioid substitution program, which runs out of the Northern Health building on Third Avenue, began accepting participants in June last year. It’s the first program offered in the city that incorporates support from the Northern Health mental health and addictions team.

“I wish this program would have come here a long time ago,” Davis said.

When he was 15, his back was broken after a car hit him. At the hospital he said he was given morphine to manage the pain and by his late teens he was using opioids regularly. Davis tried several times to end his addiction by attending detox centres in the U.S. and even one on the East Coast.

In the 1980s, while he was making a living as a fisherman, he started a methadone program in Terrace during his time off the boat. The challenge was that the doctor wanted to see his patients every day, and Davis said he would take the bus to see him but it wasn’t reasonable.

He also couldn’t get enough methadone prescribed to him for when he was back on the boat. “I was going fishing for two weeks at a time so I went without the methadone on the boat and so I would have to buy more (drugs) off the street when I got back,” he said.

Many years later, after moving around to the Lower Mainland and then Vancouver Island, he returned to the North Coast and tried a program out of Kitimat. “But in the middle of winter it takes you like six to eight hours and sometimes the road is closed and you can’t get up there,” he said, listing another challenge and another reason why Prince Rupert needed its own program.

But it was difficult to find a doctor who prescribed methadone or even find a family doctor.

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Public health emergency and fentanyl

Davis said he has overdosed more than 20 times and has counted 40 friends die over the years. In Prince Rupert, there have been five illicit drug overdose deaths this year between January to May.

Fentanyl is the big F word in the province lately. In April, the provincial health officer Dr. Perry Kendall declared a public health emergency after a significant spike in drug-related overdoses in B.C. — many from fentanyl. The Coroners Service hasn’t confirmed any fentanyl-related deaths in Prince Rupert but Davis has noticed a rise in people using the drug in the city. He also tried fentanyl himself.

“The first time I tried it I did just a little bit and I wasn’t satisfied so I dumped more. I didn’t like it. It’s not like heroin. I just started sweating,” he said, shaking his head at the memory.

His arms and legs are covered in scars from years of using a needle to inject heroin but since the opioid program started in Prince Rupert, this is the longest Davis has ever been clean. The scars are healed over now and only show up as pale spots speckling his skin.

His arms and legs are covered in scars from years of using a needle to inject heroin but since the opioid program started in Prince Rupert, this is the longest Davis has ever been clean. The scars are healed over now and only show up as pale spots speckling his skin.

Dr. Michael Melia, the health services administrator for Prince Rupert and Haida Gwaii, said when he researched the need for a methadone program in 2012, there were only six people in the city able to access the drug. It’s also unclear when methadone was last offered in Prince Rupert.

“They would have had to travel to either Vancouver, Terrace or Kitimat and they wouldn’t have had the links to counselling and social support that we think are really important,” Melia said.

Physician shortage

The need for the program in the city, and in many northern communities, has been known about for a long time, Melia said, particularly because addicted drug users don’t have access to a physician who is able to prescribe methadone.

In 2012, Northern Health found that there were only 17 general practitioners who would prescribe methadone and there were only four active programs in Smithers, Quesnel, Fort Saint John and Prince George. These programs are what Melia said are best practices where you have a local mental health and addictions teams working with a physician.

“Just giving someone methadone without the associated counselling and support could still be effective. But you limit your opportunities to really help people make change,” Melia said, and Davis’ experience speaks to that.

Physician shortages in the region slowed down progress in developing a methadone program until Northern Health connected with the Alliance Clinic in Surrey.

Doctors at the clinic were working with a patient from Prince Rupert who could no longer travel to see them and they wanted to find a way to continue to support this person.

Dr. Allan Brookstone, one of the partners at the Alliance Clinic, and Northern Health, came up with the idea to have two physicians from the clinic travel to Prince Rupert monthly. They will do the initial assessment in person to determine if a patient is right for the program — as per the College of Physicians and Surgeons of B.C. requirements — and afterwards they will see the patient weekly via telehealth, live video conferencing.

Prince Rupert gets a methadone program

Chris Melenberg, at Northern Health Addictions in Prince Rupert, was one of the leads with Dr. Brookstone to get the ball rolling. “Other programs like this exist in Northern Health but this is unique in that we have doctors coming from outside the community,” Melenberg said.

“Every week they’re also providing telehealth clinics and so clients will need that anywhere between every week to every four weeks depending on where they are at and how stable they are and how new they are to the program,” he said.

The program has 24 participants since it began in June, an increase from the six people that were on programs and travelling outside of the city in 2012.  Melia said he thinks the program can support up to 30 people.

“It’s huge. When we did the environmental scan some people were travelling 300-400 kilometres each way just to access this — people with limited resources,” he said.

“If we keep the door open then there’s more of a chance that you’ll hit the right person at the right time and you can really make a difference.”

Davis has wanted to be free of his addiction for a long time and with a regular sustainable methadone program available barrier-free in his community he said he finally feels normal. He’s even gone back to school to upgrade his skills.

“I praise these guys from the Alliance Clinic for coming up here. They saved me for sure. Hopefully they’re going to save a lot of other people but we should have had this up here years ago,” he said.