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Lawsuit against B.C., pharmacists' college, drug company over medication switch

VANCOUVER — A drug user "forced" to switch to a reformulated methadone treatment introduced in British Columbia six years ago has filed a proposed class-action lawsuit against the provincial government, the college of pharmacists and a pharmaceutical company.

Laura Shaver was among an estimated 18,000 people given Methadose instead of methadone, a change she said Friday was done without consultation and puts patients who relapse at risk of death from illicit street drugs that could contain fentanyl.

Shaver and others taking compounded methadone as part of a daily treatment program to try and quit opioids such as heroin have maintained that Methadose is a weaker medication and causes painful withdrawal symptoms for a high proportion of people who end up seeking street drugs to cope.

"I hadn't used heroin in four years or something," she said. "Within six days I was a raging injection junkie again. The things I went through, the sweats, the shakes. I don't even know where to start."

Shaver, who heads the B.C. Association of People on Methadone, said the withdrawal symptoms were so severe she took illicit drugs and overdosed eight times.

"They did not give me or anybody else a choice," she said of the province's decision, adding despite awareness that Methadose caused an increase in relapses, overdoses and deaths, it refused to allow access to methadone as part of a change she believed saved money.

The Health Ministry, which is named as a defendant in civil claim filed in B.C. Supreme Court, made the switch to Methadose in 2014 but the Ministry of Mental Health and Addictions was created two years later as overdose deaths related to fentanyl were increasing and the province declared a public health emergency.

A spokeswoman for the Ministry of Mental Health and Addictions said the province had not yet been served with the court document.

The ministry did not immediately provide comment on the allegations.

Drug company Mallinckrodt Canada ULC, and its parent company Mallinckrodt Plc, are also named in the court document but neither returned a request for comment. The College of Pharmacists of British Columbia said it did not wish to make any comments about the change to Methadose, which is dispensed by pharmacists.

"The defendants knew or ought to have known that restricting patient access to compounded methadone and granting Mallinckrodt the right to distribute Methadose as the exclusive (therapy) medication in British Columbia could result in relapse and harms associated with relapse," the court document says.

It says the province, the drug company and the college exaggerated the relative efficacy of Methadose and asserted that patients who switched from methadone should expect no adverse effects and downplayed or denied the risks associated with the change.

All three defendants are liable for making negligent, inaccurate and misleading representations to Shaver and members of the proposed class action, as well as pharmacists and doctors, the statement of claim says.

None of the allegations have been proven in court.

The lawsuit also alleges the charter rights of Shaver and other proposed members of the class action were infringed as a result of the "forced switch" to Methadose.

Shaver is claiming damages, restored access to methadone and costs.

The BC Centre on Substance Use recommends Suboxone as the first-line treatment for opioid use disorder because it has fewer side effects, is safer and can be taken home instead of being taken in front of a pharmacist. Methadose is recommended next, followed by slow-release morphine.

Jason Gratl, a lawyer representing Shaver in the lawsuit, which a judge must certify as a class action, said people who relapsed on methadose deserve compensation to try and restore their "shattered lives."

"Numerous individuals and organizations have come forward to try to persuade the province and the college of pharmacists to restore access to compounded methadone," he said, adding the change would be without cost. 

This report by The Canadian Press was first published June 5, 2020.

Camille Bains, The Canadian Press

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