Drug overdose deaths are on the rise. In fact, they’ve doubled in Surrey over the last decade. A drug called naloxone is saving lives on Surrey streets and Health Canada just made it available without a prescription. But even experienced drug users aren’t immune to the rash of deadly overdoses that has struck the region. Click here to read part one in this series.
It’s every parent’s worst nightmare – watching your child die.
Yet that was Donna May’s reality on Aug. 21, 2012.
That night, May returned home from walking her dogs to find her daughter Jac, a longtime addict, overdosing.
“I could hear the normal sounds of an overdose,” she said. “The laboured breath. The snoring. The gurgling sounds. I flew upstairs.”
Jac was rushed to hospital, where May watched as her daughter’s ribs were broken during CPR. She stood by as Jac inhaled her own vomit before going into cardiac arrest and ultimately succumbing to the overdose.
Narcan, also known as naloxone, was within arm’s reach at the hospital that night. The synthetic drug, often referred to as an “overdose antidote,” could have saved her life.
It wasn’t used.
Surrey’s Gateway shelter uses it every day.
“I didn’t even know what naloxone was until I read the name of the drug in my daughter’s coroner’s report,” said May.
Since that day, she’s fought for change: Change in access to naloxone, change in the perception of drug users and change in drug policy.
She’s spoken at countless conferences, held rallies on Parliament Hill, and founded momsDU, (Moms United and Mandated to Saving the Lives of Drug Users), which has lobbied for naloxone to be available without a prescription.
That became a reality on March 22.
It’s exciting news for May. And she thanks the federal Liberal government.
“I have gotten further in having my words heard in the five months of Liberal reign, than I have in the 38 months I advocated for change during the Conservative government’s slamming of the door on my nose,” she said.
May now hopes to see naloxone become as common as a Band-Aid.
“It should be in every medicine cabinet in the country and the world. Just in case. There are no negative effects to this drug other than putting somebody into a withdrawal,” she remarked.
May said her grandson once asked her why she supported naloxone. After all, wasn’t is just an excuse to use drugs? A failsafe?
“I said, ‘Honey, if your friends are doing drugs anyway, don’t you want to be able to save their life?’”
May now carries naloxone with her wherever she goes.
“I won’t let somebody else’s child die.”
Jac’s story is not one of peace or happiness. Her life revolved around drugs, crime and violence for the better part of her adult life.
Jac, pictured, bounced between her mother and father’s home as a teen, spending some time in foster care. She had her first child at 17, another at 18.
Jac’s opioid addiction “took off” after being prescribed oxycontin for pain after falling down a flight of stairs at about 19.
After her father’s sudden death in 2004, May could tell something was wrong.
“She acted strangely and impulsively.” Jac was also pregnant with her third child, who she gave birth to at age 22. The children in her care were taken away by the ministry years later, after they didn’t attend school for weeks.
Not a year after, Jac and a boyfriend were on the run after a shooting during a drug deal went south, said May. Jac entered a women’s shelter but soon began stealing and prostituting herself.
“We began to notice a pattern that she would be arrested and released immediately, then a day or two later there would be a major bust,” recalled May.
“We weren’t the only ones who noticed. So did the dealers and traffickers.”
May believes a hit was put out on Jac – she was beaten in 2010, suffering a broken orbital bone, broken jaw and head lacerations.
Jac fled from her hometown of Sault Ste. Marie, Ont., to Surrey in May of 2011, immediately after testifying at the trial of her attackers. She stayed at a shelter, then a “recovery home,” said May.
Within months, Jac developed plural septic pneumonia and was in Surrey Memorial Hospital until just before Christmas, then returning to the recovery home. May said within a matter of days, she was dealing for a trafficker.
“It was then that I realized that it wasn’t a recovery home at all and was not only taking money from me, but also had Jac on welfare,” May added.
Weeks later, Jac was back in hospital. She had a flesh eating disease, contracted through drug use. Doctors told the family they’d have to amputate both legs.
When May arrived, doctors had not amputated, “as it was too late.” The infection had spread too far. May was told Jac likely had just a few days left.
“Jac believed she could recover,” said May. “She told me she wanted us to try to use that time to right some of the wrongs she had done.”
In February 2012, May took Jac back to Ontario to care for her. She was in and out of hospital for infection treatment and more surgeries.
The week of her death, May thought Jac had turned a corner.
“For the first time I had hope. The morning of her overdose, she had gotten up in the morning, made her own bed, had a shower on her own for the first time and had dressed and put makeup on for the first time since becoming ill.”
Around noon, Jac received a phone call that disturbed her. “I found her crying at the garden table. She told me she was so sorry for screwing up her children’s lives and felt she could never be forgiven.”
May soon realized Jac had removed her fentanyl patch, prescribed for the pain of her flesh-eating disease.
“She showed signs of flushing it down the toilet. Our rule was I take it off, I inspect it. She broke that confidence,” said May.
After dinner, she walked the dogs and returned to find Jac overdosing.
She sat in hospital as Jac’s respirations and heart rate declined. Jac was revived and taken to critical care where she remained in a coma. She had been oxygen deprived for 22 minutes, by May’s count, and brain death is said to occur at just 15.
“If Jac survived off of artificial respiration, she would be severely handicapped. The family decided to let nature take its course.”
Jac died without waking up about eight hours later.
The autopsy revealed Jac had a fentanyl patch in her esophagus – the one she claimed to have flushed.
It also showed Cymbalta, a medication May takes for anxiety.
“Everything of hers was locked in a safe… My medication was in the bathroom drawer. I never thought for a minute you could overdose on it. But it was enough to throw her over the edge,” said May.
“It was something that would allow her to end her life.”
May vows to continue her fight in honour of Jac, now turning her attention to safe injection sites and other drug policy reforms.
“This is for her,” she said. “But it’s for the others that have not yet died because they don’t need to… There is recovery.”
SAFE INJECTION SITES NEXT STEP
Dr. Mark Tyndall, executive medical director for BC Centre for Disease Control, applauded Health Canada’s decision to make naloxone prescription-free, but said it’s far from a solution to the “public health emergency.”
The drug death tally in B.C. in 2015 was 474, 100 more than 2014. Another 132 died in the first two months of 2016.
Naloxone becoming prescription-free, he said, “doesn’t change much for the more street-entrenched user.”
He explains. “They’re likely not in a position where they’d be able to walk into a pharmacy and buy a kit. It’s not going to be covered by Pharmacare, and we don’t know how much the pharmacies will charge for it.” The change will largely help arm caregivers, friends or family of opioid users with naloxone.
BCCDC already offers free naloxone kits to users through its Take Home Naloxone Program (towardtheheart.com). Since August 2012, the program has trained 6,835 people and helped to reverse 488 overdoses in B.C. “It’s unlikely that (the prescription status change) will mean much to people who are already getting naloxone kits through our program.”
Tyndall said naloxone is a “very downstream intervention.”
While successful when used during an overdose, many people are found dead of overdose hours or days later. “Naloxone is a critical intervention that’s given as early as possible. Relatively few people are picked up that early.”
More engagement is what’s needed and according to Tyndall, that’s best done through safe injection sites.
“It has a lot of opportunity, as seen with Insite (in Vancouver) to engage people in longer-term care from medical care, mental health care and housing care.”
Tyndall has worked on Surrey’s 135A Street in Whalley a couple times a month for about a decade.
He said the way people are treated there is “abysmal.”
“Every morning they come and clear the streets of people. The resources going into the police and the dump trucks and the city workers is crazy. The people doing it know it’s not really helping anything. Everyday they just clean up the streets and push people into some fields and two hours later they come back.”
Tyndall said better help could be offered with minimal investment.“We could put up a tent tomorrow with a couple nurses on a lot in Surrey. It could happen in an hour. It’s just the bureaucracy and the exemption status that people are concerned about. I feel we should wave that and move on. This is a provincial matter.”
Going through normal federal channels would optimistically take two to three years, he said. “By then, there could be several thousand deaths. That’s not an appropriate response.”
Tyndall said the perception of addicts also needs to change. “These people may be down on their luck but certainly don’t deserve to die. We need to be much more empathetic toward the plight of people and give them a fighting chance.”
NEXT WEEK: After a man overdosed in her arms, Erin Schulte armed herself with naloxone. How you can too.