Opioids: A Public Health Crisis

How Do We Protect Our Kids from the Opioid Crisis?

Why some parents want the power to involuntarily admit their children to treatment programs

BY


iStock / KatarzynaBialasiewicz
iStock / KatarzynaBialasiewicz

A few hours before the clock struck midnight on New Year’s Eve heralding 2017, Sean O’Leary pulled into the driveway of his home in Kanata, Ontario, and found a nearly dead teenager. The seventeen-year-old—a friend of his daughter—had been attending a party at a nearby home and had overdosed on fentanyl. O’Leary immediately started performing CPR on the teen while another of his daughter’s friends called 911. Paramedics arrived and gave the boy a shot of naloxone, the antidote to the opioid. The boy, to O’Leary’s surprise, came back to life.

A tragedy was averted, but the small suburban community near Ottawa would soon see the deaths of two other youths, both caused by opioids. O’Leary, a local small-business owner, felt as though he had to do something to address the ongoing crisis, so he wrote an open letter on Facebook addressing other parents in his community. In it, he talked about the boy in his garage, other recent overdoses in the area, and how addiction had impacted his own sixteen-year-old daughter, Paige. “My first thought every morning is to check that Paige is alive,” O’Leary wrote. “It is a nightmare of a way to live life especially when you have other children and have to try to make their lives as normal as possible.…Our family dealt with it the best we could with the limited resources that are available to families in situations like ours.”

Within days, his message went viral, gaining some 400 likes, nearly 1,000 shares, and more than 100 comments. Many parents came forward to ask about ways to help their own children. “I was hoping to get ten or twelve families to meet at a small furniture store in Kanata, and what I got was something like 2,000 messages and emails,” says O’Leary. Sensing the need in the community, he then created We the Parents, a website dedicated to sharing resources for how to navigate the health care system, lobby government, and organize community meetings to combat opioid addiction.

But the family members of these young people have found that there are significant barriers to helping their kids. In most provinces, minors can often refuse health care, and they can also refuse to share medical records with their guardians. And, once children reach the age of majority, family members no longer have any legal right to intervene at all—they can be involved only as much as their child allows. Many parents are saying that these are ineffectual gaps, rather than important privacy features, contributing to the harm of the very youths that the health care system is trying to protect. Because of this, some parents are calling for changes. “I have heard from hundreds of people who have lost their kids,” O’Leary says. “With all the response I received, how many kids have passed, it’s incredible. The system is broken.”

The issue of consent is a challenging one. In Ontario, as in most other provinces, minors have control over their health care decisions, unless a doctor deems them incapable. When kids under eighteen make the choice to go into a treatment program for mental-health or addiction reasons, their parents cannot interfere in their decision, unless that child decides to share information or invite their parents or guardians into the process.

Some parents are now trying to change this system and, in doing so, are trying to rebalance young people’s safety with their rights for privacy and autonomy. The most notable example to date is the Safe Care Act, a private member’s bill introduced in British Columbia legislature in 2017 that aims to give parents more power to have children who are dealing with substance-abuse and mental-health issues admitted involuntarily into treatment programs and held for assessment. The bill was created following the death of Steffanie Lawrence, a fifteen-year-old girl from Squamish.

Steffanie’s father, Shaun Lawrence, started a petition for the change and has urged other parents to add their signatures in order to prevent more deaths of BC children. “In this province, parents of addicted and at-risk youth have no power or say when it comes to getting care for their children,” Lawrence wrote on the petition’s page. “If children in BC who are under the influence of drugs and/or alcohol refuse treatment or care, there is nothing parents can do to help their kids.” As of July 24, 2018, it has received more than 12,000 signatures.

The Ontario Drug Policy Research Network reported that there were 669,674 opioid users in the country in 2015. While hospitalization rates increased across all age groups by more than 30 per cent from 2008 to 2015, according to the Canadian Institute for Health Information, the greatest change during that period—62 per cent—was seen in youth aged fifteen to twenty-five. Public Health Ontario reported that 70 of the 867 opioid-related deaths in the province in 2016 were youths aged fifteen to twenty-four.

In Kanata, the crisis started with fentanyl in counterfeit Percocet, a pain reliever with similar makeup to strong Tylenol. “It’s finding its way into drugs that you wouldn’t think it would, like putting a downer into cocaine,” says Josh Clatney, a twenty-one-year-old from Kanata who became involved with We the Parents. Clatney has been dealing with his own addiction issues for the past few years—he has spent time in jail due to drug-related charges, and he has overdosed numerous times in the past. He recently lost two friends to death by overdose.

Clatney says that there are many barriers for young people addicted to opioids and trying to quit. He describes seeing few treatment beds in drug-detox and recovery services when trying to get help for his own addiction issues. “If you’re under sixteen, it’s going to be very difficult for you to find an appropriate detox centre,” he says. In Ontario, there are only three medically supervised withdrawal centres, none accept in- patients under the age of eighteen, and they can have wait lists of up to a few weeks.

O’Leary agrees that the complicated system of treating addiction is tough on parents, who may not know how opioids work or where to seek treatment for their child. “There are forty-six agencies in Ottawa that deal with addiction,” he says, referencing the number that comes from Ottawa Public Health. “They don’t know what each other are doing half the time, and they’re all underfunded, so they’re all scrambling for money.”

Monica Lockie is one parent who says that she would have benefited from more accessible resources. While living in Keswick, Ontario, her twenty-one-year old son Cole died from an accidental fentanyl overdose in February 2013. When seeking treatment for her son, Lockie says that there was no single place to go to get help; rather, there were a whole slew of agencies that were difficult to find. “As parents, we felt really shut out,” she says. “We tried to help Cole, we were open, but after he turned sixteen, we weren’t allowed to discuss many things with his professionals that he was dealing with. And, of course, after he turned eighteen we didn’t have any rights at all.”

Lockie says that, on one occasion, Cole did ask for help, but by the time he got to see a doctor, he had calmed down, tired himself out, and seemed okay enough for the doctor to put him on a six-month waiting list for another appointment. It was because of Cole’s anxiety and embarrassment about his addiction, Lockie says, that he became secretive about his pain and recovery needs. She says that this made it all the more difficult for his parents to intervene.

Almost two decades ago, an initial attempt to write safe care legislation was shelved in BC legislature due to civil-liberty concerns. But with the recent wave of opioid deaths claiming more young lives in the province, the Safe Care Act might finally have the support it needs from parents and the general public to be made into law.

On April 20, 2018, Elliot Eurchuk, a sixteen-year-old from Victoria, died from an accidental overdose, which his mom, Rachel Staples, says started with an opioid prescription for pain management for numerous surgeries he had due to sports injuries.

“Elliot, being 16, was given full autonomy by the Health Care system to make his treatment decisions while specifically having my husband and I excluded from this information,” Staples wrote in an emotional Facebook post following her son’s death. “This policy needs to be changed. Parents need a say in their child’s health care. The rest of the story is textbook for this sad and preventable ending.” Staples told reporters that she asked doctors for pain-management alternatives, and for access to her son’s medical records, but was told that he had the autonomy to make his own medical decisions.

Diane Sowden, executive director of Children of the Street Society, a Coquitlam group that works with vulnerable youth, has a daughter who started using heroin twenty-five years ago. She co-authored the report on safe care legislature for children in 1998 and has been lobbying the BC government ever since to give parents of children up to the age of eighteen the right to intervene. “A child’s right is to have a parent or caregiver that can keep them safe when they can’t do it themselves,” Sowden said to Global News. “They need to detox, they need longterm treatment, they need support.”

Another parent all too familiar with being shut out of the health system is Sandra Tully, whose twenty-two-year-old son Ryan Pinneo died of an accidental fentanyl overdose in 2016 in their Kamloops, BC, home. Tully says that her son wasn’t experimenting with fentanyl but a drug that he consumed contained fentanyl, causing his death.

Because Ryan was an adult, his parents did not have access to information about his recovery and say that they there could not intervene. “You feel very helpless as a parent, when you can see your child is struggling but you can’t act on their behalf,” says Tully. She says that Ryan did attend a five-day detox, but that there was no coordinated public system in place that would help him transition from medically assisted detox to rehab and other supports. It’s up to the patient to seek further help after detox, but patients may be unlikely to do so. “I think if someone is in the depths of their addiction, they also need someone to advocate for them,” says Tully. “If your addiction results in your inability to care for yourself, that should warrant some intervention, but right now, that is not the case.”

However, critics of safe care legislation, such as BC’s Ending Violence Association (EVA), argue that incarcerating youth for treatment should be avoided until a “culturally competent network of diverse and voluntary services are available to children and youth across the province.”

“Children and youth are rights-holders and must play a role in determining the character of supports and services that will best support them in their most vulnerable circumstances,” states an EVA report from September 2017. In the report, the association strongly opposes the proposed legislation and suggests instead that “resources can be directed towards establishing safe, culturally appropriate housing and treatment programming for vulnerable children and youth to move away from an incarceration model.”

Youth opioid death rates continue to rise across the country. If passed, BC’s Safe Care Act could bring parents some comfort in knowing they have more power to intervene. But the bill could take years to become a law, if it even makes it that far. And while the conversation around stigma in drug use and addiction has begun to shift, parents desperately seeking help for their children dealing with addiction and mental-health issues want changes to happen quickly. As Tully says, this is an incredibly dangerous time in history for young people to be experimenting with illicit drugs. “We as a society treat many diseases that are caused by choices a person makes, but for some reason, people think that those struggling with addiction issues should not have the care given to other diseases,” she says. “Education and awareness are so important in turning this around.”

Vesna Plazacic is a Toronto-based journalist whose work has appeared in Maisonneuve, This, Cottage Life, and Abilities.



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