'Variety store' model of dispensing addiction treatment drugs needs review, councillor says

A London city councillor is calling on Ontario regulators to take a look at the operations of New Dawn Medical, an addictions clinic that's partnered with five pharmacies in the city to distribute medication, including pharmaceutical opiates, to patients with addictions.

In a letter to Ontario's College of Physicians and Surgeons and its College of Pharmacists on Thursday, Coun. David Ferreira is calling for a "regulatory review" of New Dawn Medical, which has dozens of locations across Ontario.

Ferreira said the pharmacies affiliated with New Dawn Medical, in particular the Medpoint Care Pharmacy at 248 Dundas St., have become problem spots triggering regular complaints to his office about problems such as open drug use, property damage, sanitation issues and safety concerns.

Ferreira said the pharmacies use a for-profit "variety store" business model, with a focus on "volume, speed, and prescribing activity over continuity, integrated supports, and long-term stabilization."

He said patients often receive prescriptions after virtual "appointments" in which doctors connect with them via video link inside the pharmacy. He said more supports are needed beyond simply prescribing and dispensing.

"These clinics and pharmacies don't provide the proper aftercare that's required to support this high-risk, vulnerable population," said Ferreira. "These patients are prescribed opioids but they leave the clinic without a clear supportive path. The gap in care doesn't just affect them, it spills over into the neighbourhood."

Ferreira said he supports the safe supply approach to addiction treatment. Under that model, patients receive doctors' prescriptions for pharmaceutical-grade drugs, such as hydromorphone and methadone. It's an approach designed to help patients avoid the often toxic street supply of illegal opiates, including fentanyl. The synthetic opioid is a driver of fatal overdoses in an ongoing opioid crisis that is linked to 2,200 deaths in Ontario last year alone.

Medpoint moved to Dundas Street, directly across from the Central Library's main entrance, after its tenancy inside Citi Plaza ended, in part due to security problems.

In a statement to CBC News, Downtown London interim executive director Vicki Smith said Medpoint is "negatively impacting nearby businesses" and reducing the sense of safety among "customers, employees and neighbouring businesses."

"Our members are approaching this with compassion, recognizing the complexities connected to services such as these pharmacies and the role they play in the community," said Smith, who added that Downtown London is working with London police and city officials to address the issues.

New Dawn clinics are affiliated with dozens of pharmacies across the province. The company has a focus on helping patients with opioid addiction and chronic pain. The five Dundas pharmacy locations are listed on New Dawn's website. However, in a statement to CBC News, a spokesperson said New Dawn clinics operate as separate "independent operations" inside the pharmacies in which they're located.

Dr. Warda Farooq, who works with New Dawn, told CBC News that patients aren't simply issued prescriptions automatically, but take part in a rigorous, monitored program to carefully treat their addiction. She said patients are assessed and must provide regular urine tests to confirm they're taking the medications as prescribed.

"We don't want them using fentanyl, and this is a way to manage their addiction."

Farooq said some of the appointments are virtual because the patient group doesn't do well with set appointment dates. She said typically patients are required to take some of the medication in front of staff before leaving with the rest of the medication. Many have to come back to the clinic every day.