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The fee is not charged at publicly operated clinics, but space restrictions mean private clinics are sometimes the only option for methadone patients to access treatment.

John Lehmann/The Globe and Mail

The British Columbia government is allowing private methadone-dispensing clinics to charge recovering heroin addicts for drug treatment by taking money from their income-assistance cheques, claims legal action launched against the province.

Documents filed in B.C. Supreme Court on Wednesday advancing what could be a class-action lawsuit claim private methadone clinics demand $18.34 a month from people enrolled in the methadone maintenance program in exchange for treatment.

Lawyer Jason Gratl, acting on behalf of the representative plaintiff, Laura Shaver, said the money is paid automatically from their government-provided benefits. "This scheme is deeply unethical," he said.

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"If the province wants to compensate doctors and pharmacists for additional hardship and troubles associated with the methadone program they're free to do so but they shouldn't do so on the backs of those least able to pay."

The documents claim that Ms. Shaver, who is addicted to heroin and unable to pay for treatment or counselling, signed a government-drafted Alcohol and Drug Fee Authorization Agreement "unwillingly and under duress" in order to receive methadone treatment from Yale Medical Centre in downtown Vancouver.

The fee agreement is $60, reduced by $41.66 through a government-provided Alcohol and Drug Supplement. The remaining $18.34 is drawn from a client's monthly support allowance, the documents state.

"This is not okay," said Adrienne Smith, a lawyer with the legal advocacy organization Pivot Legal Society, which aims to defend society's vulnerable and marginalized. "Medically necessary treatment should be provided without user fees."

The fee is not charged at publicly operated clinics, but space restrictions mean private clinics are sometimes the only option for methadone patients to access treatment, Ms. Smith added. "For people on income assistance the amount of the fee is a tremendous hardship," she said. "Eighteen dollars a month could mean the difference between fresh vegetables or not."

Mr. Gratl estimated as many as 12,000 people could fall in the same category as Ms. Shaver and be involved in the class-action lawsuit, though it has yet to receive approval by a court.

The annual cost of methadone treatment per patient in the province is just over $4,200, according to court documents. The cost of untreated opioid dependence is between $40,000 and $45,000, factoring in considerations such as health care, law enforcement and other social costs, the document states.

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The government's policy is also a barrier to people accessing treatment, Mr. Gratl said. "It just doesn't make any sense because the methadone program has such high social advantages; the tradeoffs are just so heavily in favour of methadone maintenance," he said.

"It's to everyone's benefit, including the people on methadone, to have this program running strong. So any kind of disincentive to entering the program seems to be a species of tomfoolery."

None of the allegations have been proved in court. The B.C. government didn't return a request for comment on the lawsuit.

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