Methadone clinic doctor faces hearing over allegations of misconduct

The owner of a number of Ontario methadone clinics is facing a 10-day hearing before the College of Physicians and Surgeons of Ontario for "disgraceful" and "unprofessional" conduct.
The owner of a Hamilton methadone clinic on Main Street East near Tisdale is facing a hearing for unprofessional conduct. Owner, Dr. Michael Varenbut, denies the allegations. (Denise Davy)

The owner of a Hamilton methadone clinic is facing a 10-day hearing before the College of Physicians and Surgeons of Ontario for "disgraceful" and "unprofessional" conduct.

Dr. Michael Varenbut's hearing begins in February and will deal with allegations that he "failed to maintain the standard of practice of the profession" and that he "engaged in disgraceful, dishonourable or unprofessional conduct in relation to his treatment of and dealings with a patient between approximately 2002 and 2009."

Methadone is a synthetic narcotic that is used to wean addicts off drugs such as heroin and reduces harmful withdrawal effects from the opioids. The Hamilton clinic at 397 Main Street East, which opened in March 2005, has 203 clients and is one of about 50 methadone clinics owned by Varenbut who is founder of Ontario Addiction Treatment Centres.

The Notice of Hearing sets out one allegation that Dr. Varenbut is "incompetent" and two additional allegations that he has "committed acts of professional misconduct." Both the College and Varenbut's lawyer, Chris Wayland, stated that they could not provide any details about the allegations.

"This is the extent of the information that is available about the allegations prior to the hearing," said College spokesperson Kathryn Clarke.

The hearing is scheduled for February 19 to 22; April 1, 2,  3 and 5; and September 23 and 24.

If found guilty, Varenbut could face revocation of his certificate or a fine of up to $35,000.

If his certificate is revoked, he is permitted to apply for reinstatement after one year.

Varenbut 'denies all allegations'

Varenbut's lawyer, Chris Wayland, stated in an email that his client "denies all allegations" and "looks forward to his day in court."

"He trusts that everyone concerned with the case will be fair-minded and will understand that the allegations are just that — allegations. They have not been proven and there are two sides to every story," Wayland wrote.

Wayland said the allegations do not relate to the Hamilton clinic.

The Hamilton clinic is part of the province's massive methadone treatment program, a multimillion-dollar program funded almost entirely by the provincial government. Costs for the methadone alone were more than $21 million in the 2011-2012 fiscal year, paid for through the Ontario Drug Benefit Program.

Costs to operate the clinics, as well as fees paid to the 373 physicians who provide the treatment, were not available from the Ministry of Health and Long Term Care.

Ministry spokesperson David Jensen said the ministry also provided an additional $1.2 million in 2010 and 2011 to various provincial organizations to increase access to methadone maintenance treatment, improve professional services (physician, pharmacist, nursing, counseling) and increase awareness in communities about the value of methadone maintenance treatment. 

Methadone is a narcotic that weans addicts off other drugs

The College began administering the methadone program on behalf of the MOHLTC in 1996.

College spokesperson Kathryn Clarke said they keep a patient registry to ensure patients only receive treatment from one clinic at a time. They currently have a list of 38,565 patients in Ontario who are receiving methadone for the treatment of opioid addiction.

The Main Street East clinic is one of several methadone clinics in Hamilton. Although the clinics are technically business, they do not require a municipal business licence and there is no category for these types of businesses within the By-law, according to city hall spokesperson Debbie Spence.  

Varenbut has a controversial history with OATC which he founded in 1995 with Dr. Jeffrey Daiter. According to OATC's web site, more than 10,000 clients have been treated at their clinics and they are currently treating one third of the entire patient population in Ontario who are consuming methadone.

Patient died in 2005

Since last August, Varenbut has had practice restrictions placed on him by the College that prevent him from performing or being involved in the provision of an ultra-rapid opioid detoxification, also known as anesthesia-assisted rapid opioid detoxification. Those restrictions were placed on him as a result of the death of one of his patients in 2005.

The patient, John Martellacci, a 27-year-old Woodbridge electrician, died suddenly at the clinic following the rapid opiate detoxification. Wayland said the upcoming hearing does not involve this issue.

Then in 2006, following a Toronto Star investigation of OATC, one of their companies was found guilty of improperly billing the Ontario Health Insurance Plan and fined $25,000.

Dr. Varenbut and Dr. Daiter agreed to make a $250,000 voluntary payment to the provincial Health Ministry after pleading no contest.

The College's Standards and Clinical Guidelines states there is extensive medical literature showing that methadone reduces morbidity and mortality associated with heroin addiction. One study found that patients were three times as likely to die without methadone treatment than if they were maintained on treatment.