When Mary Purdy died of a suspected fentanyl overdose on January 17, she became another victim of an opioid crisis that killed more than 900 people in British Columbia last year and has made fentanyl a household word.
She also left behind two young children, underscoring the multigenerational impact of the overdose epidemic and raising questions about what more could be done to prevent people from turning to illicit drugs and to help them if they get hooked.
"Almost all the women we know who have died [of overdoses] have kids," says Janice Abbott, chief executive officer of Atira Women's Resource Society, a Vancouver-based group that provides housing and support to women and children affected by violence.
"I think we have to pay more attention to how violence and trauma impact women and substance abuse."
It's not known how many children under the age of 19 may have been orphaned or lost a parent as a result of an illicit drug overdose. The B.C. coroners office doesn't track that information, citing variables – whether kids are living with one parent or both, or in government custody, for example – that would make it difficult to come up with reliable figure.
B.C.'s Ministry of Children and Family Development says there has been no increase in the number of children coming into government care that corresponds with the recent surge in overdose deaths; in fact, the number of children in care has dropped in each of the past five years and currently sits at about 7,000.
On average, about 25 children come into government care each year as a result of losing their parents or guardians, the ministry says.
In Alberta, the Ministry of Children's Services is monitoring the issue but "current evidence does not support the assumption that fentanyl-related neglect or abuse is specifically leading to more children and families receiving services," a spokesman said.
An increasing number of critical injury or death reports filed over the past few months to B.C.'s Representative for Children and Youth – an independent office that oversees the child-welfare system – involve youth injured through drug use, either by themselves or their parents.
"It raises concerns for me and for our office," children's representative Bernard Richard said in an interview. "We're hearing it's an issue … I think the whole province is adjusting to what is obviously a significant crisis."
But children are being left behind.
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Mary Purdy was one of eight children and grew up primarily in the United States. She was also the mother of eight children; her youngest, aged four and six, were with her when she died, family members say.
She had friends and family on the Downtown Eastside and was connected to several support agencies, including Sheway, which supports pregnant women and mothers who are dealing with drug and alcohol issues.
On Facebook, she posted pictures of her children and, often, of food: homemade turkey soup, fried chicken and cupcakes.
Her sister, Marie Purdy, says Mary's substance-use problems escalated after their father died in a car accident in 2008, and that she had overdosed at least once before the overdose that killed her.
Mary Purdy's death has triggered a wrenching family tug-of-war.
About a week after she died, Marie – who lives in Vancouver and has children of her own – sought and obtained a court order that granted her guardianship of her sister's two youngest children.
But at a hearing Thursday, a provincial court judge overturned that order after learning that, soon after Mary Purdy died, a social worker had met with the boys' father, Lorne McMillan, and his sister to develop a safety plan for the children.
That safety plan included two provisions: That as caregivers, Mr. McMillan and his sister would not have anyone under the influence of alcohol or drugs around the children and that nobody but Lorne McMillan or his sister would care for the children without the prior approval of the social worker.
Outside court following the hearing, Mr. McMillan said he was happy and looked forward to seeing the boys.
But Marie has longstanding concerns. She says she sought guardianship of the boys out of worries for their health and safety. She says the boys' teeth were not being looked after and worries about Mr. McMillan's past.
In January, 2013, Mr. McMillan was charged with one count of assault causing bodily harm. According to court documents obtained by The Globe and Mail, that charge related to an incident in January, in which he "ripped open Mary's lip with his finger, causing a tear from her lip down to her chin."
According to court documents, Mr. McMillan pled guilty and was sentenced to attend treatment at an alcohol and drug treatment centre. A court order following that incident, from Nov. 6, 2013, also ordered Mary to stay away from drugs or alcohol while caring for the children.
But that supervision order had expired and was not in effect when Mary died.
At the hearing Thursday, a social worker with the Vancouver Aboriginal Child & Family Services Society – a provincially delegated agency that provides child welfare services to aboriginal families in Vancouver – said she most recently saw Mary in November, when they talked about closing her file.
After Mary Purdy died, Mr. McMillan passed a drug test and agreed to a safety plan, the social worker said.
A lawyer representing Mr. McMillan read aloud to the court letters of support for him from two doctors who had treated Mary and Lorne for several years. More than a dozen friends and relatives, including his sister, who testified on his behalf, were in court to support him.
On Thursday, Judge Rose Raven said the two children were to be returned to the father's care.
Marie Purdy says she has contacted all of her sister's other children, who are older and live elsewhere in the province, about their mother's death and is planning a funeral.
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Typically, when a child's parents die and that child is left without a legal guardian, parents have made provisions for a child's care. If not, family members can apply to a court to become a guardian. Neither of those scenarios involve the Ministry of Children and Family Development.
If there are no such provisions in place, the children's ministry tries to place children with extended family or with people they know, as long as those people are deemed safe and appropriate caregivers.
"This is always the preferred choice as it makes the transition easier for the child," a ministry spokesman said recently in an e-mail.
If those options aren't available, the ministry would seek custody through the courts and then put the children in foster care.
But in some instances, parents who die of overdoses have children who are already in care – having been placed there as a result of a parent's substance use or other concerns.
For children in those circumstances, the overdose death of a parent means an interrupted relationship can never be restored.
"There are kids who have gaps because their mothers have been absent in their lives," Atira's Janice Abbott says. "I worry about the impact on those children. There's already a huge gap when you're apprehended … and then your opportunity to ever figure it out is gone"
In the past three months, 11 women died of overdoses at Atira sites, more than had died of overdoses over the past decade. That prompted Atira to open monitored "shared using" rooms in some of its housing, beginning in late 2016. (Ninety per cent of illicit drug overdoses in 2016 occurred inside, with 61.3 of those in private residences, says the B.C. Coroners Service.)
In January, Atira announced one of its buildings – the Rice Block, a 38-unit building in Vancouver's Downtown Eastside – would be a "substance-free" space for women seeking recovery.
The Rice Block beds are among a host of steps the provincial government is taking to tackle the opioid crisis, including new overdose-prevention sites, take-home naloxone kits and improved access to treatments such as Suboxone and methadone.
While welcoming those harm-reduction steps, advocates would also like more focus on the reasons why people use drugs.
Vancouver mayor Gregor Robertson has called for increased investment in housing and mental-health services to complement harm-reduction measures such as providing front-line responders with naloxone.
Increasingly, public-health officials – including Vancouver Coastal Health's chief medical officer Dr. Patricia Daly – are talking about decriminalizing or legalizing illicit drugs and providing legal substitutes.
Editor's note: A previous version of this story said Mary Purdy's father died last year. In fact, he died in 2008.
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