This is the presentation MSTH co-founder Leslie McBain gave together with Dr. Christy Sutherland at the Family Medicine Forum (FMF), the largest gathering of family physicians in Canada. The event took place in Vancouver BC from November 4 to 7, 2019. #MyFMF #FMFVancouver

The experience of losing a child from any disease or from any cause is the most devastating in life. Most of us who have lost a child, utter the words, “I would give my life to have them back”. The grief lasts a lifetime.

The impact on families from the preventable and stigmatized death of a loved one from drug harms is profound. Parents may be isolated, judged. Partners frequently split, siblings may be sad, anxious and become at risk themselves, extended family can be judgmental and distant yet also grieving. Friends, co-workers, a religious community, the medical community are affected. There are a lot of people grieving across this country right now. And statistically 11 more people will die today. My own count of drug related deaths since my son died in 2014 is over 14,000.

After I lost my son Jordan at 25 to an accidental overdose of prescription medications – I started to learn in a deep way what addiction was and is. Believe me, hindsight may be a good thing but it can be very painful.

My own story about my son’s journey of addiction, highlights many failures of the system. I do not totally blame the system, and I finally no longer blame myself. But our stories can help to change the system and those that work within it, and I hope families, to move forward in a good way.

Jordan was a funny, popular, highly energetic, risk taking boy. Home life was stable and comfortable. In his middle teens Jordan was drinking and smoking pot with his gang of close friends on the weekends down at the swimming hole in our rural community. Most kids were doing this to one degree or another. We parents were aware and policing this as best we could.

By age 18, his dad and I could see the problem arising, that Jordan was overusing alcohol, pot and possibly other drugs.

Allow me to count the failures which in my opinion exacerbated my son’s addiction and finally the path to his death.

Fail #1 – Back in 2004, 5, 6 Our family had no education on problematic substance use. We didn’t see his risk taking, highly energetic behaviour as something we should treat, though we were vigilant.

Today in 2019, education is available but not widespread in schools, in parenting education manuals or meetings. If it is even available it is often based on scare tactics, such as the DARE program or Just say No messaging. Educators have few resources to address mental health issues.

Fail #2 – Recovery facilities have few regulations and almost no oversight

Jordan asked to go to a recovery facility when he was 19. We were lucky to get him into one, but though it was very, very expensive, there was a great lack of professionalism and individual care. Jordan left after 6 weeks of a 12 week program because he thought he’d recovered. He relapsed about a week later. We now know that relapse is very likely.

Many recovery facilities seem to be either terrible, lacking in hygiene, basic care, trained staff, and security, or they are prohibitively expensive. The entire spectrum, good and bad is not well surveilled. And very few clients are subsidized by the government. Families mortgage their homes, use college funds, retirement savings. They are desperate to get their kids healthy

Fail #3 our Family doctor knew very little about addiction, and he bought the Big Pharma line that oxycodone is not addictive.

From age 19 to 22, Jordan used cocaine, alcohol, and other drugs in a problematic way. He did not think he had a problem. He had his own small business. He had a steady partner, a rented home, pets and friends. But he was addicted. during this time he sustained a fairly minor back injury on a job. He went to our family doctor. The doctor immediately prescribed oxycodone.

Fail 4 The family doctor did not see the value of including family in the plan for healing.

I went to Dr Mike (my doctor as well as Jordan’s) after about 10 days of Jordan using oxy, and told him Jordan was at risk of addiction. I did not ask for information. I did not suggest treatment options, I simply gave important information to Dr. Mike. He thanked me for the info but continued to prescribe ever increasing amounts of oxy for 7 months.

Jordan became severely addicted within a short period of time. Over time He was not getting the amounts of opioid he needed to not go into withdrawal. His behavior became desperate and ugly. Finally, He came to me saying he needed to get off oxy and would I go see our doctor with him to get help. And of course I did..

Fail #5 Stigma in the doctor’s office office

The doctor became really angry, he yelled at Jordan for letting himself become addicted. He said rude and demeaning things to both of us. Finally he fired Jordan as a patient before we walked out the door. This doctor personified stigma, which is at the ground level of our failures as a society to adequately address this epidemic.

Between Jordan and I, we made an appointment for a detox bed in Victoria.

Fail #6 The wait for a detox bed was 12-14 days.

Because he was withdrawing Jordan was at high risk of not making it the 12 days. I helped him find the drug he needed to make it to detox. Detox is detox, it is only a possible first step on the path to recovery, it is for many a courageous first step, an admission of and a willingness to solve a problem.

Fail #7 After detox, we could not find any support –

the only counselling was a large group that met in a hospital that was 30 km from Jordan’s home. We could not find a psychiatrist or an addictions doctor or anyone to prescribe Suboxone, which jordan had researched himself. We had nothing.

Jordan relapsed within a few months. He began to doctor-shop, and was able to access a compendium of pharmaceuticals in a short time. namely oxycodone, hydromorphone, benzos and anti anxiety meds.

Fail #8 Doctors often do not use Pharmanet (does everyone have this?)

Not one walk-in clinic doctor nor Jordan’s ophthalmologist checked pharmanet to see what Jordan had been prescribed over that past weeks and months.

One day, when he was alone at home, he ingested each drug in a therapeutic amount, and the combination stopped his heart.

These failures in part, resulted in the death of my beautiful only child. The ultimate tragic failure. This was not an illicit fentanyl poisoning, which is a result of prohibition and the attending black market. These failures were not a result of severe untreated mental illness, trauma or poverty, But these failures were also major system failures in the crisis of addiction and overdose. This is something we, you can fix. We may not be able to fix every person, but we have the ability to fix fatally flawed systems.

Please understand that families can often, though not always, be one of your greatest resources. Stressed families are often desperate, scared and sometimes difficult. But they are most strongly invested in the patient’s recovery.

As you go forward please try to include supportive family members as you can. It can be the patient’s best and sometimes only support system. And who knows more about the patient than the mother?

Confidentiality need not be breached, but what I say here, and it is easy for me, but more difficult for you, Go Rogue! If you can save a life, use your instincts around parent/child confidentiality. Everyone can be kept safe.

Please take a deep and honest look at your own stigma. Learn as much as you are able about addiction, what it is, how it behaves, evidence- based pathways to recovery, and all harm reduction measures. Know that one size does not fit all, that each person may need a different pathway.

Two other Moms and I created Moms Stop the Harm in 2016 after all losing our sons to drug harms. We have about 1300 members across Canada. Our goal is to stop the deaths by convincing policy makers to enact measures that support the lives of people who use drugs.

One of our less elegant mottos at Moms Stop the Harm is that “a dead drug user will never recover”. All harm reduction methods must be utilized. Safer supply and delivery of it must be examined and implemented. We must keep them alive.

One other saying I will leave you with is something I recently read in a wonderful novel called the Overstory, it is about trees and families.

A father asks his children regularly “When is the best time to plant a tree? 20 years ago, the children answer. “When is the next best time”, he asks? The answer is, NOW.

Let’s start right now to stop the deaths. It is in our power.