Getting away from the underground

Moose Jaw Police tackle the over prescription of drugs

by Lucas Habib
When it comes to law and order, the small city of Moose Jaw, Saskatchewan has a history as colourful as its name. At the turn of the century, city buildings were mostly heated by steam. To service the boilers without enduring the frigid prairie winters, engineers constructed an elaborate network of tunnels beneath the downtown. During American prohibition, the Soo Line railway ran straight from Moose Jaw to Chicago; consequently, vice-based businesses began opening up shop in the tunnels and "The Jaw" became a hub for bootleg liquor distribution to the Windy City and across the US. Moose Jaw became known as 'Little Chicago' and AI Capone is rumoured to have visited numerous times (although no proof actually exists). Nearly a century later, Moose Jaw's biggest law enforcement problem isn't bootlegging - it's prescription drug abuse. Whether in big cities, rural areas or remote First Nations reserves, prescription drugs are a growing crisis across Canada. Law enforcement agencies are battling the problem with some success, yet the problem continues to intensify. Prescription opioids have been the leading cause of accidental overdoses in the US and Canada since 2001 and property crime has increased in many areas to feed these addictions. According to the International Narcotics Control Board, as of 2008, Canada had the highest per capita consumption rate of oxycodone in the world. In Moose Jaw, oxycodone and morphine are the two main problems. In 2009, Cst. Taylor Mickleborough ofthe Moose Jaw Police Service was getting tired of dealing with drug-related property crime. His creative thinking skills led to his finding a way to help the Jaw's opioid addicts while simultaneously reducing crime. From his confidential informants, he discovered that the city was well-known throughout Saskatchewan as a place where opioids were the drug of choice. "We also learned that Moose Jaw had a few doctors with inappropriate boundaries in their prescribing habits," recalls Mickleborough. "We had drugs that had originated from a few local doctors that were being discovered during investigations in other jurisdictions. We were also told that users from other areas were coming to Moose Jaw to obtain prescriptions from those few doctors." Mickleborough and his team approached the doctors but had mixed results. Clearly, traditional approaches weren't improving the situation - it was time for something new. They came up with a "pretty simple idea," says Mickleborough. The College of Physicians and Surgeons of Saskatchewan has one pharmacist on staff, Doug Spitzig, whose job
MAY 2012

Moose Jaw Police Cst. Taylor Mickleborough with Saskatchewan College of Physicians and Surgeons Pharmacist Investigator Doug Spitzig. is to monitor misprescription and overprescription of drugs, but he was missing a critical piece of information - street-level intet. "All we did," says Mickleborough, "was reach out to him ." Police collected a list of about 50 high-risk users and dealers from their proven-reliable sources. After some crossreferencing and fact checking, they handed the list to Spitzig, who in tum drafted letters to the doctors in question, asking them to justify their prescriptions to the suspected abusers and traffickers. With this approach, the doctors said they were pleased that drug misusers had been identified and agreed to help. To date, Mickleborough and Spitzig have been very happy with the physicians' response. Despite this initial success, Mickleborough and Spitzig recognize the problems might recur. Now that the college is involved there are options for regulatory discipline of wayward physicians, including hearings, loss of prescribing license, competency assessments and investigations into non-professional conduct. So far, it hasn't come to that. "We've already seen both quantitative and qualitative results," states Mickleborough. Forty-two percent of the identified misusers on his master list either had their prescriptions ended or dose-tapered - but Mickleborough emphasizes that cutting off drugs an addict may need is not the solution to a drug abuse problem . Dose-tapering can be helpful, though. Since the program started, Moose Jaw's support services have seen a corresponding increase in detox participants. Significantly, prescription drug addicts who have had their allotment reduced as a result of this initiative have been supportive. "Many of the
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street-level users know they need help-they see doctors as the source of their problem," Mickleborough emphasizes. "It's important to express that we've never talked to a single prescription drug addict who doesn't hate their addiction - it stops them from leading a normal life." Mickleborough stresses that the program is still in its infancy. "This is the beginning of what we see as a long process ofeducation, enforcement and support for both local users and traffickers." He also hopes that other jurisdictions adopt a similar strategy. He and Spitzig have been invited to present at conferences in Saskatoon and Ottawa - to police, doctors and representatives from the Canadian Centre for Substance Abuse. They presented their strategy to a very enthusiastic board of doctors from the local health region in March. Dr. Brad Thorpe, president of a regional medical association, says physicians "knew that the problem was out there but were ignorant to the extent of it." The presentation was such an "incredibly positive learning experience" they've requested additional seminars for other doctors, he noted. "There isn't a lot of discussion between police, doctors, mental health and addiction professionals and drug addicts," says Mickleborough. This program is one way of opening those tunnels of communication. Mickleborough, Spitzig and the Moose Jaw Police Service hope to bring those people who need help up from the underground and towards the light.
Moose Jaw Police Cst. Taylor Mickleborough may be reached by phone at 306 694-7600 or by email to tmickleborough@mjpolice.ca. Lucas Habib is a freelance writer for Blue Line Magazine.

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