Ontario’s optometrists are not winning hearts or respect among non-opioid patients. As a result, their gripes over patient access to methadone and suboxone programs have led them to the brink of a union contract. Last week, optometrists took their fight to Ontario’s health minister, urging him to intervene. Matthew Guidry, an optometrist based in Mississauga, told Dr. Eric Hoskins: “At our heart, our aspiration is to be a nurse practitioner.” Dr. Ted Simpson, director of the Ontario Network of Community Health Care, sided with the optometrists, imploring the minister to “have the courage to stand up for our patients” who are “caught up in this mess.”
The optometrists insist that they would not object to methadone and suboxone if patients could receive the medications through “locally developed” off-site clinics. Patient-advocacy groups, including the Ontario Society of Addiction Medicine, oppose the optometrists’ calls for co-locations, saying the province is on track to deliver methadone and suboxone through six permanent, funded off-site clinics. But those are just the beginning. The optometrists want the government to invest $100 million a year in off-site sites, and local advocates say a deal could lead to the creation of “drug clinics” on average 40 minutes away from where patients live.
This becomes an even more pressing issue because Ontario’s total methadone expenditures are expected to hit $1.7 billion this year, as the province’s desperate opioid epidemic worsens. Part of the plan to deal with the situation calls for the province to pay all of the medical staff at 12 sites owned by the Ontario Drug Benefit Program, at an estimated cost of $700,000 a year. Medical staff at additional off-site clinics could eventually cost $4 million a year.
That’s $7 million the province can’t afford. And yet, as two doctors said in their testimony before the health committee last week, “we aren’t asking for more money in our current contract. We are asking for protection and maintain our current deal.” Not an unreasonable request, especially in light of the province’s pressing opioid crisis, which, according to one recent study, is claiming 1,500 lives a year.
Follow up story: Anna Maxwell