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HealthWellnessAddictions9TuesdayFebruary182014OverdosesparkslookintoopioidtreatmentinNWTByMEAGANWOHLBERGTheNWTschiefcoroneriscallingforareviewoftheterritorysprescriptionofchronicpainmedicationsandsubsequentaddictionstreat-mentfollowingtheoverdoseofanAklavikwomaninDe-cember2012.CoronerCathyMenardre-leasedherofcialreportonthedeathofArleneCarmi-chael47whowasfoundtohaveaccidentallydiedfromaspirationpneumoniacausedbytheingestionofmultipledrugsinherhome.Post-mortemtoxicologyre-vealedthepresenceofseveralopioidsandbenzodiazepinesinherbloodstreamincludingmorphinecodeinediazepamparoxetineandzopicloneamongothers.Thecombinedeffectsofthedrugswereca-pableofcausingaspirationpneumoniaMenardsaid.ThoughCarmichaelreceivedanexcellentqualityofcareMenardsaiditappearedevi-denthercareproviderslackedtrainingandexpertiseinthemanagementofprescriptionopioidandbenzodiazepineaddictiontodealwithCar-michaelsongoingdependency.Carmichaelregularlysawdoctorsfornarcoticandseda-tivemedications.Hermedicalrecordsshowedshesufferedfromchronicpainosteoar-thritismigrainesanxietyanddepressionhypothyroidismdiabetesandlong-termalco-holanddrugabuseandthatwithdrawalsymptomsmayalsohavecontributedtoherhospitalvisits.OnseveraloccasionsshereceivedearlyrellsonopioidsandbenzodizepinesfromherprimarycarephysicianandondifferentoccasionsshepresentedtotheemergencydepartmentrequestingearlyrellsonhermedicationsMenardwrote.MenardsaiditstimetheNWTdepartmentofHealthandSocialServicesestablishedaworkinggrouptosetstandardsfordoctorsandnursesontheprescribingofchronicpainmedicationsandreviewitseligibilitycriteriaforthecov-erageofsuboxoneadrugusedinopioidreplacementtherapy.Thoughlesseffectivethanmethadonesuboxoneislesslikelytocauseoverdosingandcanbeprescribedwith-outaspeciallicense.Itisgiventhroughstructuredopioidtherapywhichlimitsmisusethroughfrequentdispensingregulardoctorvisitsforurinedrugscreeningandagradualreductionindosages.Asimilartaperingap-proachisusedforbenzodi-azepineaddiction.InestablishingservicesforprescriptiondrugaddictionMenardsaidtheregionalhealthauthoritiesmustworkcloselyinconjunctionwithcommu-nitiesandAboriginalgovern-mentsnotingthatinnorthernOntariowhereopioidabuseishighsomesuboxonepro-gramsarerunindependentlybyFirstNations.Menardaddedthatmoretrainingandsupportisneededforphysiciansandnurseprac-titionersintheNWTtoiden-tifyandmanageopioidmis-useandaddictionthroughtelemedicineandbyprovid-ingaccesstoalong-distanceclinicalsupportnetwork.ShesaidoneormorephysiciansshouldbeintensivelytrainedonsuboxoneadministrationintheNWT.Itappearedevidenthercareproviderslackedtrainingandexpertiseintheman-agementofprescriptionopioidandben-zodiazepineaddiction.NWTChiefCoronerCathyMenardFormerNWTdoctorwantsnameclearedafter10yearslivingwithchildabuseallegationsByMEAGANWOHLBERGTenyearsagoonFeb.4Dr.RichardBargensworldcamecrashingdownaroundhim.Thephysiciannow68wasworkingforpublichealthinYellowknifewhenhewascalledintothede-partmentheadsofceandaccusedofbeingacerti-edpedophileandknownchildpornographerintheUnitedStates.Theallegationsnevertobeconfirmedbyevidencewouldleadtothesecondlargestdefamationsettle-mentinCanadianhistoryandwouldalsotearhislifeapart.InafewdaysIlosteveryfriendIhadsaidBargenalongwithhisjobandhislifeintheNorth.Hecontemplatedsuicideandhaddifcultyndingworkforyears.Thefollowingweeksmonthsandyearswouldbecomeablurbuttherep-etitionofthatoneconver-sationhasstuckwithhimsinceAt300p.m.hewascalledintoameetingwithGregCummingstheformerCEOoftheYellowknifeHealthandSocialServicesAu-thoritywhowouldgoontobecomedeputyministerofthedepartmentofHealthin2006.Theallegationsthathewasaknownpedophilewasinpossessionofchildpornog-raphyandhadbreachedpa-tientcondentialitywouldleadtohisterminationwith-outanyoftheproperproto-colsbeingfollowedbythedepartment.Infactitwouldbead-mittedafteraneight-yearlegalprocessthatCummingshadactuallylookedintothebackgroundofBargenbe-foreringhimonlytobetoldbytheRCMPthattherewasnoevidencefortheac-cusationswhichwerebasedonhearsay.Heproceededtotermi-nateBargenspositionregardless.Thoseallegationsandthewrongfuldismissalthatfol-lowedwouldleadtooneofthelargestdefamationandslandersettlementsinthecountrycostingtheterrito-rialgovernmentandNorthernmedia-specicallyCBC-massiveamountsofmoneyinapre-trialsettlement.Yetitisasettlementalmostnooneknowsabout.WhileBargenwouldre-ceivethenancialreparationsAfterahorribledecadeofcomingtotermswithwhathappenedtohimtheonlythinghewantsnowisforhisgrandchildrentoreadthetruthwhentheyaresearch-ingonline.sinceMarchorAprilof2004.Nothingelsehasbeenheardofme.Ivelongpassedthepointofwant-ingtosayhowbadlyIwasdonebybutIrealizethatwhenmygrandkidsstartlookingthingsupthatwillbethepublicityaboutmeiftheygoogleme.Therewillbenothingelseaboutasettlement.AfterthesettlementwhichfinallycametoanendinSeptember2012Bargensaidheattemptedtohavethemediacorrectthemisinformationtheyhadpublishedbuttheyre-fusedtoevenprintapaidadvertisementfollowingthesettlement.Hesaidhewasnotpre-paredfortheshadowthefalseaccusationswouldcastovertherestofhislife.Googlemakestheworldadifferentplacehesaid.Reectingbackontheor-dealheismystiedabouttheforceandswiftnesswithwhichthegovernmentbu-reaucracydismissedhimwithoutdueprocessthatwouldhaveallowedhimtorespondtotheallegationsneededtoestablishalifeelse-whereandpaybackhisdebtsfromyearsofjoblessnessthelackofatrialwouldleavehisnameuncleared.AndbecausemediawerelegallyimplicatedhesaidtheychosetoneveragainmentionthenameofDr.RichardBargen.ThatwassortofonethingthatwasmissingfromallthisbecauseIsettledbeforegoingtoatrialhesaid.Ihadnopublicvenueanditsquitedisturbingtometothinkthat...thatsallthatseverbeenreportedYoucantrunagovernmentandalsogiveoutlargelegalawardsthatareaconse-quenceofaremediableawinphiloso-phy.Thatshowitappearstome.Itrustandhopethisneverhappensagaintoanyone.Dr.RichardBargenandgethisjobbackratherthanlosehismedicallicensebrieyforeverscarringhisprofessionalcareer.HesaidhenowseesthehealthdepartmentintheGNWTashavingbeenaharshenvironmentwherecutthroatindividualswouldresorttounethicalactionstomaintaintheirpositions.Inevermetasinglegov-ernmentemployeeintheNorthwhowouldntswearhismotherwasachipmunkifhewasthreatenedwiththelossofhisjobBar-gensaid.Canadiansdownsouthhavenoideaofhowpowerfultheideaofcon-sensusofbeingonboardofnotrockingtheboathowpowerfulthesecon-ceptsare.Bargensaidhehopesbutdoubtsimprovementshavebeenmade.Youcantrunagov-ernmentandalsogiveoutlargelegalawardsthatareaconsequenceofareme-diableflawinphilosophyhesaid.Thatshowitap-pearstome.Itrustandhopethisneverhappensagaintoanyone.JusticeDefamationNWTCoronerCathyMenardsaystheNWTneedstoreviewitsprotocolsforopioidandbenzodiazepineprescriptionandaddictiontreatment.