Daphne Bramham: Lack of addictions treatment for youth needs urgent fix
Credit to Author: Daphne Bramham| Date: Wed, 12 Feb 2020 23:12:30 +0000
As B.C. heads into the fifth year of a public health emergency due to the high number of opioid overdose deaths, Vancouver Island still doesn’t have a single residential-treatment for youth. Provincewide, the number of youth beds and services lag demand.
For youth who do get one of those precious treatment beds, their transition back to community-based services is badly planned and poorly managed.
Had all of that been in place, 16-year-old Elliot Cleveland Eurchuk might have survived his addiction rather than being counted among the 4,850 British Columbians to have died between January 2016 and Oct. 31, 2019.
But the teen’s legacy could be — should be — that Health Minister Adrian Dix and Premier John Horgan making addictions treatment as much of a priority as harm reduction.
Recommendations from the coroner’s inquest into Eurchuk’s 2018 death released on Monday provide some direction: More acute-care beds for youths including a residential treatment centre in Victoria; more and better access to addictions services; and resources for early detection of mental-health and substance-use disorders among youth.
For more, the government ought to dig out its copies of the 2018 report from the B.C. Centre on Substance Use that recommended a “full, evidence-based continuum of care including building an effective and coordinated addiction treatment and recovery system that has traditionally been lacking.”
That report also singled out the need for youth-specific services and treatment including residential care. It also recommended “recovery high schools” where not only are drugs and alcohol are strictly prohibited, treatment and services are part of the curriculum.
Men aged 19 to 59 make up the overwhelming majority of the people who have died of opioid overdoses. But, an average of 18 youths have died in each of the past four years.
The recommendations aren’t only aimed at preventing youth from dying. They’re aimed at providing treatment to prevent their addictions from becoming entrenched.
In addition to the recommendations, the coroner’s report provides a glimpse of the other opioid crisis far away from Vancouver’s Downtown Eastside.
Eurchuk knew about harm reduction services, but he didn’t get his drugs tested, didn’t go to safe injection sites, didn’t seek treatment or replacement therapies such as methadone or Suboxone.
He’d started using cannabis in November 2015 when he was 13. After injuring his shoulder wrestling a year later, he began self-medicating, buying hydromorphone from a classmate at Oak Bay High School.
In December 2016, he broke his jaw playing soccer and, after surgery, was prescribed hydromorphone for the pain. Two months later, he had the first of two surgeries on his shoulder and was prescribed another opioid, Tramacet, for the pain.
After reinjuring his shoulder that fall, Eurchuk was given another prescription for Tramacet. He was also suspended from school, accused of selling drugs to classmates.
After a second shoulder operation that October, Eurchuk got a five-day prescription for Oxycodone, followed up by a prescription for Tramacet.
In the final months of his life, Eurchuk was routinely using opioids to the point that when he was hospitalized in early 2018 for a serious infection, he got a day pass and got fentanyl and cocaine while he was out. He went into cardiac arrest in the hospital on his return.
He was home briefly in February before being readmitted under the Mental Health Act. Discharged after a week, Eurchuk was in the emergency room of Vancouver’s St. Paul’s Hospital in March because of decreased consciousness and released after a few hours.
On his final day, Eurchuk bought a two-day supply from a street dealer, used with a friend early in the evening and was heavily intoxicated by the time they parted ways. As the evening wore on, people who saw him described him as everything from fine to agitated to disoriented. He was last seen at midnight.
The teen died on the morning of April 10 at home from a heart attack, fluid in the lungs and aspiration caused by “mixed intoxication” from fentanyl, cocaine, heroin and methamphetamine.
Attempts to revive him with naloxone, chest compressions, suction and a defibrillator failed.
While the government will provide a written response to the coroner’s recommendations in the coming weeks, last summer it committed $2.4 million over three years to addictions and mental health programs.
It has opened four youth detox beds in Victoria. There are eight Foundry Centres across the province providing comprehensive supports with three more being developed. And, this spring, a 20-bed treatment facility in Chilliwack is scheduled to open.
There is no guarantee that better acute-care treatment, earlier interventions and more comprehensive community services will save the lives of every addicted youth or that they would have saved Eurchuk.
Addiction is, after all, a chronic, relapsing condition.
Elliot Eurchuk was just a kid and there are others like him. They deserve the best chance possible to grow up to be healthy adults.
Twitter: @bramham_daphne