MANITOULIN—Since the closing of the 19A Water Street (methadone) Clinic in Little Current this past spring, M’Chigeeng First Nation and Wikwemikong Unceded Indian Reserve have both risen to the task of developing addiction management plans for their communities and their residents. While both at different stages, as M’Chigeeng First Nation has already initiated its plan, both models reflect a focus on community-based, multidisciplinary case management and a preference to the pill Suboxone over methadone treatment.
“The program here is working well,” M’Nendamowin Health Services department manager Roger Beaudin told The Expositor during an interview last Thursday. “We work directly with the clients offering addiction counselling, an important component that was missing from the previous treatment in Little Current (through Dr. Dressler’s clinic).”
The M’Chigeeng Wellness and Recovery Case Management Team is comprised of M’Nendamowin Health Services in partnership with Dr. Dressler’s office, the Mindemoya Guardian Pharmacy, the Manitoulin Central Family Health Team, Ontario Works and Addiction Services Initiative.
Sam Gilchrist, the alternatives program worker at M’Nendamowin Health Services, explained that what makes the program work so effectively is its ability to “envelope clients into a circle of care” which provides clients with the best chance of recovery.
Under the program, M’Chigeeng band members battling opiate addiction receive their intake at M’Nendamowin, which also manages their treatment plan. They also go to M’Nendamowin for on-site counselling, monthly appointments with Dr. Dressler through the Ontario Telemedicine Network and for urine testing with support from Dr. Dressler’s office. The methadone is dispensed to clients at the Mindemoya Guardian Pharmacy, and due to a decision from chief and council, no take home methadone treatments are permitted.
“We have also begun switching clients over from methadone to Suboxone (an alternative opiate addiction treatment to methadone) and plan on putting new clients directly on Suboxone,” added Mr. Beaudin. “Research shows that clients who use Suboxone have a shorter time frame of getting off the drug, while with methadone, you could be using the treatment for life.”
“Suboxone has a better track record for getting individuals off the medication,” said Mr. Gilchrist. “It is also more difficult to be abused because of an additive called naloxone, which makes someone go into severe withdrawals if injected instead of taken orally.”
Mr. Gilchrist explained that Suboxone comes in two forms including a pill, used by M’Nendamowin clients, or a dissolving strip that is placed under the tongue.
“The tricky part with Suboxone is that right now is isn’t covered under the Ontario Health Care Plan and it costs more than methadone,” continued Mr. Gilchrist. “You have to be on the Ontario Disability Support Program in order to be eligible.”
On the other side of Manitoulin, Wikwemikong has also been working diligently on addressing the needs of its community members living with addiction, recently approving a Community Wellness Development Strategy and Action Plan.
Though community members are currently travelling to Sudbury to receive addiction treatment from Dr. Dressler’s Larch Street Clinic, Chief Duke Peltier told The Expositor that Wikwemikong is “exploring its options” regarding a clinic and/or treatment program in the community.
“The Community Wellness Development Strategy and Action Plan complements our Comprehensive Community Plan from 2012,” said Chief Peltier. “The strategy focusses on a holistic approach, looking at health promotion and development, risk reduction, active treatment, early identification, brief intervention and after care.”
Chief Peltier explained that the plan is also grounded in community-based, multidisciplinary case management.
“The biggest element that council has discussed is the after care and how important counselling is to any treatment,” added Chief Peltier.
Chief Peltier also expressed that moving forward, if the community was to have its own clinic, that Suboxone would be council’s preference for treatment.
“The preference of council is Suboxone as a primary treatment, but we also understand that it depends on the clients needs and phase of treatment,” said Chief Peltier. “We would also likely move to a no take home policy if there was a community clinic in place.”
Outside of Wikwemikong and M’Chigeeng, the Manitoulin Addictions and Mental Health Partners Committee—composed of mental health and addictions health care professionals from across the Island—is working to identify gaps in the current system and better support client care.
“Right now, other than M’Chigeeng First Nation, individuals are referred directly to a licenced physician for methadone, such as Dr. Dressler’s clinics in Espanola or Sudbury,” explained vice chair of the committee Christine Blake, a registered social worker with Health Sciences North’s Mental Health and Addictions program.
Ms. Blake added that there is addiction counselling available from the various health teams across the Island.
“One of the concerns we are discussing is the access to treatment programs,” said Ms. Blake, “and offering ongoing support to clients.”
When asked if the committee has discussing lobbying for an addictions treatment clinic (methadone and/or Suboxone) available to all Island residents, Ms. Blake responded that that was not in the committee’s purview.