Inside the methadone clinic
“Straight up the stairs and to the right. And if you need anything, I’ll be outside,” says Steve Hannes, the Victoria Park Clinic security guard as I make my way into the methadone clinic for the first time.
If I need anything? I’m an independent, young student. I eat new experiences for breakfast. I still haven’t put my foot on the first step.
“Don’t be scared,” Hannes says, laughing.
Should I be scared?
I’m just one of over 100 who walk through the yellow-brick door frame at the corner of George and Dalhousie Street that day – but many of them have been there before.
The Victoria Park Clinic has been at the centre of Brantford’s downtown for nine years and at the centre of a debate for nearly two. In March 2012, the committee for the Downtown Brantford Business Improvement Area (DBBIA) released an issue and recommendation paper to the City of Brantford stating their concerns with the location of the Victoria Park Clinic. Since then, the issue has gone to council, sparked discussion of a detoxification centre and had patients wondering whether their treatment would be secure next year. With this in mind, I swallow my concerns and walk up a narrow staircase to find something different than I ever expected: a very sterile, stark-white, average-in-every way medical waiting room.
Am I in the right place?
The sterile room, lined with stiff, structured plastic chairs hosts three doors, one to a reception office, one to a doctor’s office and one to a pharmacy counter.
“Jaime,” the receptionist in loose, teal scrubs calls from behind a glass partition. “Your ‘carries’ are ready.” A young woman, no older than 20 rises from her seat and walks to the pharmacy counter to pick up a case of small canisters before returning to her seat and tying up her dark hair. Another name is called, and the patient in question follows the same regimented pattern. Then another. And another.
It’s like a machine.
I’m still standing in the doorway, an obstacle to new patients who seamlessly enter the structured flow. In an attempt to clear the path, I walk quickly to the empty seat opposite the young woman with dark hair to introduce myself. As I sit down, our bodies mirror each other.
Her dark hair mimics my own. We’re about the same height. She’s so young. No, we’re the same age. We were probably obsessed with Barbie at the same time. We probably watched the same shows on YTV. We probably started high school in the same year.
“I take methadone because of my son, he’s 4 years old. I can’t be a mom when I’m on Oxy,” Jamie Lee Laforme begins. “I’ve been on the program for almost four months now – and this week I can take carries.” She holds up the case of tiny canisters, each filled with a 50 mg dose of liquid, drinkable methadone.
“No clean piss, no carry-homes.” An older man in a black, minor-hockey windbreaker leans over Jaime to shake my hand. The sleeve of his right arm reads ‘coach.’ “‘Name’s Jim Lafleur, and its not my first time here either,” he says.
Jaime is just one of the Victoria Park Clinic patients from Hagersville, Ont. who Jim Lafleur and wife, Sherri volunteer to drive to Brantford multiple times every week. Unfortunately, a lengthy trek is not unique. Roughly 175 patients drive from Cambridge and nearly 200 are from Simcoe.
“We found Oxy in my son, Marcel’s room two years ago. And we knew Jaime, his girlfriend, was using too,” says Jim. “I think we reacted differently than most parents – we offered to drive to the clinic.”
Jaime, boyfriend Marcel Lafleur, 20 and friend Jordyn Hill, 24 frequent Jim and Sherri’s half-hour shuttle to the clinic. Each of them at a different stage of tapering off their dosage, they are but 3 of the 700 seeking methadone treatment in Brantford and 37,000 seeking treatment in an Ontario. The high demand for a response to opiate addiction has the province asking ‘why methadone?’
Dr. Jatinder Singh Dhillon, a physician at Victoria Park Clinic answers this question daily, to his patients and to those who oppose his profession.
Dr. Dhillon’s office overlooks the Darling and George Street intersection where students from Wilfrid Laurier University and patients alike make their way across the congested streets. The city hall building is visible no more than one block away.
“It’s like a constant reminder of the clinic’s current insecurity,” says Dhillon.
Annette Fitch of the DBBIA lists the reasons suggesting that the City of Brantford relocate the Victoria Park Clinic as “loss of parking, loss of customers, parking abuse, loitering, garbage, vandalism, drug paraphernalia.” A full year after the letter became public; a tripartite debate between the City, the DBBIA and the clinic is still manifest in downtown Brantford.
“It goes against best practice to have this sort of business near parks, schools, retirement homes and places of religious worship,” explains Mark Gladyz, Brantford’s City Planner. “And here we have a methadone clinic right inside a church.”
The Victoria Park Clinic, like any other business downtown is a lease-occupying tenant who pays rent to St. Andrew’s United Church. The owners of this clinic, Fred Hussey and Mark Simone have not been silent in the past year’s discussion.
“This is a service that needs to be provided. We’re located in a central area, with decent parking and ease of access to transit and other services downtown,” says Hussey. “It would be a human rights issue to relocate.”
The Victoria Park Clinic opened in 2006 — occupying the same street corner for seven years, never relocating as the neighbouring university grows or businesses come and go.
“People are tentative to invest here because of the struggles Brantford’s downtown has seen,” says Gladysz.
Incentives are offered to desirable businesses wishing to open and expand downtown. The city’s master plan is geared towards making the downtown a cultural, commercial and office destination. A methadone clinic does not fit easily into one of these categories.
“The services offered at St. Andrew’s church simply don’t represent the city well, especially in the heart of downtown,” says Ward 1 Councillor Larry Kings. “We need to find a location that still serves the need, but allows for growth downtown. Whether that is done through friendly discussion, rezoning or licensing is up for discussion.”
Jaime fidgets in her seat. She has been here nearly 30 minutes and is now waiting for her friend, Jordyn to return from the other side of the white door where he meets with a doctor.
“Every patient is different. I’m tapering off pretty slowly, but Marcel will probably graduate from the program,” says Jaime. “I don’t think it’s working very well for Jordyn.” The white door opens for the twentieth or thirtieth time since I arrived, revealing a tall, broad man.
“No carries yet,” he sits to Jaime’s left, towering over her tiny frame to introduce himself. “I’m Jordyn. What do you know about methadone so far?”
What do I know? Methadone. Used for treating opiate addictions. Not a great high. Drinkable. Six dollars a day. Dispensed here. Unless you piss clean. Then you get carries. Everyone wants carries – but good luck getting them because you have to be clean. Be clean and have a fridge. If you’re homeless, you can’t have carries.
“I don’t know if anyone has told you yet, but all you need to know is that it’s not really a fix. It’s getting through the day so you can get a job,” Jordyn interjects my thoughts, hunching over far so that his elbows meet his knees. “But it’s hard to get a job when you have to come here every morning.” He places his head in his hands.
“It just feels like I can be a little more normal,” says Jaime. “It lets me wake up without a headache and lets me go to bed without cold-sweats.”
Evidently, many patients on a methadone program do not cut out other opiates all together.
“They might still use, but they might only have to use 40 or 50 bucks-worth to get stoned instead of spending $200,” explains Brad Kidder, a social worker at Grand River Community Health. “Money doesn’t go far when supporting addiction, especially if you can’t hold a job.”
Fifty mg of OxyContin, the now delisted, prescription drug that many patients at Victoria Park Clinic are addicted to, has a street value of roughly $120. If a user doesn’t have a job, it is not uncommon to fund an addiction through theft or prostitution.
“The street value of a stolen T.V. is around 50 bucks and the going rate for an act of prostitution is 20 bucks,” says Kidder. “Users need up to $300 to get their fix. Do the math.”
Filling a methadone prescription, if not covered by personal health care, Ontario Works or Ontario Disability Support Program costs between five and six dollars per day. Though integrated in publicly funded initiatives, the Victoria Park Clinic and other methadone clinics in Ontario are for-profit businesses.
“The issue we will have is that this is a money-making venture by a corporation,” says Brantford Mayor Chris Friel. “The Ontario policy to have methadone treatment as a for-profit venture is questionable.”
“Can you stop eating? Can you stop breathing?” says Dhillon. “This is the level of addiction opiate users have and they need a solution.” Treatment however is no more than a temporary solution. It is said to supply a steady, long-lasting high that allows for regularity, employment and safe relationships in one’s life.
“Is the downtown, in a profit making structure even the best way to deal with addiction?” asks Brantford Mayor Chris Friel. “A rehabilitation centre is absolutely necessary but only part of the continuum of care necessary to deal with addiction.”
Friel leads the committee to bring a holistic detoxification and rehabilitation facility to Brantford as pitched by MPP Dave Levac in February 2012. Friel notes that the city cannot afford funding the facility despite their lead role in providing partners.
“This is a provincial responsibility,” says City Councillor and committee member Richard Carpenter.
The Mayor will pitch the need for a clinic to the Hamilton Niagara Haldimand Brant Local Health Integration Network (LHIN), a provincial group providing health services to over 1.4 million residents of the Southern Ontario region.
The waiting room continues to fill as Jim, Jordyn and I wait for Jaime’s return. The seat to my right is now occupied by a woman in her mid thirties who hands wooden blocks to the toddler on her lap. His miniature hands trace the edges before dropping them to the floor. His mother is rewarded with a large, toothless grin. A man in a pristine suit unbuttons his coat before leaning over to rescue the rogue building block. He hands it back to the toddler.
“I bet you’re surprised to see kids here, and people with money too,” says Jim, smirking.
Seats fill as quickly as they empty. Each time a name is called and a patient leaves, someone of a different age, race or economic class replaces them. I quickly become aware of the preconceived thoughts I had walking in the door.
I am so naive.
“We service between 700 and 1000 patients, but that doesn’t mean everyone seeking treatment in the area is tended to,” says Dhillon.
In order to prescribe methadone, a federal exemption is issued to doctors who have undergone extensive training. Only 370 Canadian doctors hold this certification, resulting in a lack of services and an overcrowding of the widely dispersed clinics that do exist.
Proposed relocation areas are intended to overcome the congested roadways by providing extensive parking in a semi-industrial area, ideally near the 403.
“The lots on Garden Avenue, with paid parking and poor bus access?” asks Marc Laferriere, social worker at Grand River Community Health. “That’s a disaster. What’s next, removing the emergency meal service downtown or placing a curfew on park use?”
It’s as if each person returns from the doctor’s office with a different progress report. I guess with the passing of each patient. Maybe they have made the switch from 70 mg to 60. Maybe they’ve tested clean for a whole week. Maybe they’re still feeling the burn of withdrawal in their chest. Jaime is the last person I see return from the white door to the doctor’s office that day
“So what’s this article about anyway?” Jaime asks, folding herself into the original seat opposite myself. “How everyone wants the crack-heads as far away from the university as possible?”
I hope it not about just that. I lean forward for a moment as if reaching for a better answer. Our body structures are a perfect parallel again. I try to formulate an appropriate response, returning to the mirror in my mind.
We probably felt the joys and trials of first loves, best friends and adulthood at the same time. We probably went to prom the same year. We’re probably both wondering what we’ll be doing when we’re 40.
“Everyone wants students like you to move to town,” she speaks before I’ve even opened my mouth. “But not us methadone patients.” Jamie, Jim and Jordyn all rise, ready to leave and I follow them to the door.
“I think the community will decide what its about,” I finally open my mouth in a stuttered response.
A relocation of the clinic won’t affect patients like Jaime who commute to the clinic; how the province and community address addiction will change her life.
“Maybe if you talk to more people you’ll know what you’re looking for. I’ll be back next week, so we can talk then,” Jaime says, her words echoing in the same narrow staircase I climbed an hour ago. “And probably every other week this year.”