McDONALD: How many have died waiting for changes to addictions treatment in B.C.?

I don’t know much about Brandon Jansen's life but I can tell you all about his death two years ago, as detailed by the B.C Coroners inquest into his passing.

Just 20 years old, the young man from Coquitlam was in the midst of yet another attempt to break his addiction to opioids when he died alone in his room at the Sunshine Coast Treatment Centre in Powell River.

The immediate cause of Brandon’s death was found to be overdose from heroin and fentanyl compounded by his low tolerance of them — Brandon had been released from a correctional facility straight into rehab just a week before he died.

Findings from the inquest revealed huge cracks in the unregulated industry that exists for drug and alcohol treatment in this province, cracks that played just as significant a role in his death as the drugs that actually killed him.

I call it an industry because that’s exactly what has sprung up around addiction treatment which has long been left to a patchwork of non-profit societies and private companies.

The inquest noted that Brandon had tried unsuccessfully to get clean at least eleven times before his death at a variety of private detox and treatment centres, some of which charged his family from $25,0000 to $30,000 a month.

With that kind of money at stake, it’s not hard to see how private industry would be attracted to addictions treatment as a business, especially given it is essentially unregulated except for building standards like fire escapes and the number of smoke detectors.

Treatment centres can offer whatever programming they wish from the 12 Steps to deep psycho-analysis, done in various settings from Spartan to luxurious at whatever price they choose.

Best of all, no outcome is guaranteed and no refund is usually offered. If the client relapses, they are often kicked out with the blame put back on them for failing off the wagon.

Not a bad business model, if you can get over playing on the desperation of addicts — and their families — trying to reclaim their lives.

So a broad recommendation yesterday by the B.C. Coroner’s illicit drug death Death Review Panel that the province should much more tightly control and regulate the industry is welcome news, although decades late in coming.

I first began ranting on this subject 15 years ago when I did a series of stories on unfunded recovery houses, so-called because they received no government funding other than the pooled welfare checks of the residents plus whatever they could scrounge up in private donations.

Some had the backing of a non-profit society but in many cases, it was a group of men desperate to get clean living together and trying to follow some kind of abstinence-based recovery program usually incorporating the faith-based 12 Steps.

Not surprisingly, relapse was common and so was the potential for abuse. Quite naturally, my attention turned to other organizations offering addiction recovery with the big question: How well does your program work?

One well-known local non-profit society offering a 28-day residential treatment program at the time claimed a success rate over 80 per cent.

But what that turned out to mean was 80 per cent of the clients managed to get through the four-week treatment program without getting kicked out for relapsing.

A supposedly-clean client could literally finish the program, get in a taxi and drive straight to the crack shack and would still be counted as a success story.

What little measure was made of client outcomes consisted of an annual reunion picnic where former clients were encouraged to share their success stories. Attendance was not taken.

I won’t name this organization because it still exists and is still offering drug and alcohol treatment. Presumably any problem I could still have with them will be fixed when the provincial government steps in and begins regulation.

None of this is meant to take away from the intent of the many organizations and countless people who have worked tirelessly over the years trying to help people with addictions.

However well-meaning though, the price of relapse in the age of fentanyl is too great to leave it to chance or unregulated private business interests, as the death review panel made clear.

This change has been too long in coming and I can’t help but think of all the other Brandons out there that have slipped through the cracks over the years and ended up in a coroners report.

Since his death, Brandon’s mother Michelle has emerged as a fierce advocate for changes to the drug treatment system and is herself opening a private treatment centre in Penticton which is to be based on the inquest findings.

Yet while I admire her intentions and understand her motivation, I believe the entire spectrum of care for addictions should ultimately be removed from the private sector and non-profit societies and delivered directly by health authorities.

As coroner Michael Egilson said yesterday, we don't allow unregulated acute care or mental health treatment, why do we allow unregulated treatment of addicts without measuring the outcomes?

Brandon Jansen didn’t get much of chance to make an impact in his short life, but his death could have a much larger impact through the changes it will bring to addictions treatment in this province and the lives that will save.

— John McDonald is a long-time reporter, editor and photographer from the Central Okanagan with a strong curiosity about local affairs. You can reach him at jmcdonald@infonews.ca.