Dorothy Bakker is an associate clinical professor at McMaster University.
I talked to the coroner this week. My son, Stephen Emslie, died last October with five times the lethal dose of fentanyl in his blood. I waited five months for the toxicology results of his autopsy. As The Globe and Mail recently reported, the escalating toll of Canada’s opioid crisis is reaching terrible new heights, with a projected 4,000 deaths from overdose in 2017, a 45-per-cent increase over 2016. Two mothers, like myself, poured their pain onto the page, grappling with the senseless loss of their sons.
Most people who overdose do not want to die – they “trust” their dealers and do not foresee the risk, or they are too powerfully drawn by the high to resist. Some are homeless, some use supervised-injection sites, while many die silently in their homes, and their families go on living with profound grief, stigma and shame.
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My son, Stephen, was 25 years old. He had a history of bipolar mood disorder and cocaine addiction but, like many with a chronic illness, he fought hard against the grip of his disease. He took his medication faithfully. He completed an addiction treatment program, got sober, became an AA sponsor and helped others by spreading the word about his journey of recovery. Stephen was completing his masters in engineering and the day before he died, he submitted his grant proposal for his PhD. He had a promising future. But he made a mistake. He used cocaine laced with fentanyl. Now he is dead.
Who is at fault?
Many would say that Stephen is to blame – he bought the drug. He is the one who used, but I believe it is more complicated. We are all culpable. I have been a family physician for more than 25 years. I remember the 1990s when ‘big pharma’ and colleagues in the medical profession persuaded physicians to treat pain with opioids, OxyContin the most notorious. Surgeons prescribed large quantities after dental, orthopedic and abdominal surgeries. Family doctors also prescribed it and later had trouble getting patients off the drugs they no longer should have required. Thrill-seeking teenagers raided their parent’s medicine cabinets, and dependent and addicted patients turned up at their doctor’s offices asking for, or demanding more, and more prescriptions were written.
Then the statistics started to roll in: increasing numbers of people were overdosing from the drugs we doctors had prescribed in good faith. The opioid crisis began. OxyContin was replaced with OxyNeo, a pill harder to crush, and presumably harder to abuse. Most doctors tried to prescribe fewer opioids and supported their patients through addiction treatment, while others cut off their patients cold turkey or kicked them out of their practices. The problem went underground. People hooked by the highly addictive opioids were forced to seek drugs on the streets.
Then fentanyl, an opioid 100 times more potent than morphine, infiltrated the scene. Fentanyl is diverted to the black market from legitimate prescriptions, shipped into our country through the mail and taken across the border in cars and trucks. The dealers cut it into other drugs – such as the cocaine my son thought he was using.
The coroner who investigated my son’s case did his job. He went to the scene of his death, investigated and then added him to the growing tally of opioid deaths. He found Stephen lying face down in his bed, in his apartment. He estimated that Stephen lay there for more than 24 hours after his death. No one was there to give him naloxone, the antidote our government is peddling to save our addicts. Stephen lay there alone that day, dead, while I called, texted and banged on his door, hoping he would answer.
The police appear to lack the crime-scene technologies and resources to find the perpetrators who infect the drug supply with fentanyl. Maybe some police even lack the will −a similar lethargy that I have seen in doctors, politicians and the public to recognize addicts as real people and tainting drugs with fentanyl is a crime. A lethargy that allows drug dealers to cover their tracks and to find new victims.
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I don’t have faith that police will find my son’s killer. It is manslaughter in my books. Stephen didn’t want to die. He was given a deadly concoction, not what he had ordered.
Something needs to be done. Thousands more will die.