Back in 1992, Ontarians hooked on heroin were stuck in a vortex of addiction. Effective treatment was scarce — at least in the province.Even though methadone had been around since the 1960s to treat addiction and there was compelling evidence to show it relieved intense withdrawal symptoms, it was still viewed as controversial. The idea of replacing one opioid with another raised eyebrows.Dr. Philip Berger, a Toronto family doctor with a long history of working with the most marginalized of patients, among them people struggling with addictions, was up on the latest literature.But trying to convince key Ontario decision-makers of the drug’s worth proved a Sisyphean task. Berger couldn’t get politicians and bureaucrats to see past the stigma of opioid-replacement therapy and make it more available. Direct lobbying didn’t work. Holding a news conference at Queen’s Park made no difference either.That spring, flyers began appearing in parts of downtown Toronto where people with addictions were known to hang out. The notices hailed methadone as a successful treatment option and offered a peculiar suggestion on how to get it.“If you want help or need treatment, phone Michael Decter, deputy minister of health,” they advised. His private office number was scrawled onto tear-off strips at the bottom.The tactic worked. Twenty-five years later, Decter acknowledges the flyers, along with a resulting meeting with Berger and two patients, nudged him to increase availability of methadone, ultimately opening the door to it being accepted as a go-to addiction treatment in the province.“Dr. Philip Berger knew how to move governments to action. He could be just enough of a thorn in your side to get your full attention but he never acted frivolously. I took him seriously because he drew attention to important issues,” Decter says.The victory is just one of many to which Berger has contributed during his most unique 40-year medic ...
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