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How many drug addicts with OD have brain damage? Doctors say Canada needs data



TRAVEL – Dayton Wilson stopped taking drugs when he overdosed heroin containing fentanyl, but his ability to walk and talk normally is also part of his past, as he struggles with brain damage from drugs associated with thousands of deaths.

According to his mother, 24-year-old Wilson last used illicit drugs in August 2016 in the city center of Vancouver in Eastside, but does not remember anything about the day he was taken to hospital.

It was the first of two institutions where he spent three months to learn how to take a few steps and say a few words.

According to the latest data from the Public Health Agency of Canada, between January 2016 and June 2018, more than 9,000 people died from an overdose across the country. British Colombia’s coroner service recorded nearly a third of these deaths.

But there is no complete statistics on people who have experienced the damaging effects of opioids on the brain. Doctors say that information is necessary to understand the extent of the “forgotten” victims of the opioid crisis and to provide them with help and resources so that they can become as functional as possible.

More than two years after speech, physical and occupational therapy, Wilson speaks hesitantly and is difficult to understand. He paused before answering the question of what he could remember after he was taken to St. Paul’s hospital by ambulance.

“I don’t remember this, but I didn’t breathe for about five minutes,” he said about how long his brain was deprived of oxygen.

While the conversation can be frustrating, what he regrets the most is not the ability to rap, one of his passions.

“It's a little hard for me now,” he said, adding that sometimes he falls back and beats his head.

Wilson said he started experimenting with drugs at the age of 15 before two years later became addicted to heroin. The brain damage he experienced at the age of 21 helped him understand the strength and life-changing effects of his addiction.

“I really like the man he made me for,” he said of his ordeal. "I just don't like what they did to me."

His mother, Valerie Wilson, said that she and her ex-husband refused to allow their son to live with them, as he continued to overdose in their homes even after treatment, as they were worried about the effects of his addiction on other children.

The consequences of the last overdose were difficult for the family.

“He tried to eat, and it was like watching a severe Parkinson patient,” said Wilson, seeing his son in the hospital. "He was shaking and could not keep food on his fork."

Wilson said that few people know about the effects of traumatic brain injury for those who have experienced an opioid crisis.

"One thing I often hear is:" At least you still have it. " In many cases, I like: “Well, actually not. I have his version.

She said that her son was a steelworker who walked along steel beams high in the air, and now he does not want to go to the edge of a cliff by the ocean, because he can fall.

According to his mother, the Wilson family tried to find community programs and support groups for him, but the only services available are for people not involved in this, including stroke.

“He wants to be a member of society,” she said, adding that her son recently got a part-time job as a janitor at the Kamloops Hotel, where he now lives with his father.

"Going to work is important for his self-esteem, and now that he has this job, where he, in fact, washes the toilets, he loves it."

Norma MacDonald’s daughter, Tracy MacDonald, now 44, has been addicted to prescription opioids for decades after being diagnosed with endometriosis when she was 14 years old. She suffered brain damage after the first and only overdose in July 2017.

“Endometriosis was so painful that it literally fell to the floor,” says MacDonald about her daughter, who began to “buy medicine” for methadone, oxycontin and percoceset, and ultimately was treated for dependence on the advice of her family doctor.

According to her mother, she had a relapse and an overdose, she suffered from brain damage that affected her speech and left her dependent on a wheelchair.

“When people hear that this was caused by an overdose of fentanyl, it is largely written off, and this is regrettable,” says McDonald about her daughter, who lives with her parents.

Dr. Adam Pitts, doctor of the intensive care unit at St. Paul's Hospital, where Wilson was initially treated, said that brain cells can be affected in just 30 seconds after an overdose, and the level of damage can range from mild to severe.

According to Pits, between 25 and 33 percent of patients are admitted to the ICU because of complications caused by increasingly strong drugs such as fentanyl and carfentanil, but there is currently no way to adequately collect this information.

Electronic medical records include the diagnosis of the patient upon admission, he said.

But some of these people may be diagnosed with shock or something uncertain in the emergency room, and brain injury will be determined later using later laboratory tests, which he says are recorded in a separate system.

“Frankly, this is embarrassing,” said Pitts due to the lack of data on brain injuries caused by overdose, which he would like to track on a national scale. "This is what the whole health care system should work on better."

According to Pits, without data it is impossible to determine which resources are used in hospitals, or how best to use community resources.

“How can we adjust the way we do business without having the best data to make such decisions, for example, staff or go to the government and say:“ Look at how many patients are overdosed and suffer from chronic traumatic brain injury. We need to do more primary prevention and secondary prevention, or fund rehabilitation after discharge. ”

St. Pauls will be among the hospitals in the Vancouver area to deploy a new electronic document management system in 2019 for better data collection, but it will not be streamlined throughout the province where several systems are used, he said.

Dr. Patricia Daily, Chief Medical Officer of Vancouver Coastal Health, called the lack of data on brain injuries caused by overdose as “tragic,” since neither patients nor their families receive the support they need.

"We concentrate on deaths, but we forget that there is another group of people who have suffered negatively, some of them seriously."

Nicholas Gnidzeiko, clinical administrative database manager for the Canadian Institute of Health Information, said that national statistics on brain damage associated with an overdose crisis will require developing a set of standards for consistent and comprehensive data collection, but this does not exist. System in any province.

Camille Baines, Canadian Press


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