VICTORIA — A British Columbia pediatrician who treats children and youth struggling with substance abuse issues says he supports placing young people in treatment facilities against their will if they’ve suffered an overdose.
Dr. Tom Warshawski, who treats youth in the Kelowna area, told a coroner’s inquest into the death of 16-year-old Elliot Eurchuk that an overdose is a life-and-death situation where a young person’s brain and actions are being controlled by the potentially deadly drugs.
Warshawski said Thursday that committing young people to secure treatment facilities where they can’t leave for a time period of about one week at least allows doctors to help clean the drugs out of their systems and open their minds to the possibility of future treatment.
“It’s not a panacea,” he said. “It’s not a guarantee of success. I think it’s an important tool that needs to be looked at. The choice is involuntary (treatment) versus continued life-threatening behaviour.”
Eurchuk died of an overdose in 2018 about two months after he was forcefully admitted to a Victoria youth treatment ward for a week-long stay.
The inquest heard his parents took the action when he overdosed in hospital on illicit drugs. At the time, he was undergoing treatment for a blood infection that is common to intravenous drug users.
Eurchuk’s parents, Rachel Staples and Brock Eurchuk, have testified efforts to help their son were thwarted by medical privacy laws that allowed information to be kept from them about the teen’s addiction issues.
Eurchuk denied using street drugs to his parents and doctors, and it was only after his overdose in February 2018 that he started talking about drug use with his family doctor. He refused to allow his parents into the discussion, the inquest has heard.
Warshawski said patient confidentiality is an important issue, but when it involves young people and it is life-threatening, parents should know.
“Opioid overdose is at the extreme end of risk of death, and certainly we would disclose,” he said.
Warshawski said he is part of a working group that has provided recent research documents about secure care treatment for young people to B.C.’s Ministry of Health and the Ministry of Mental Health and Addictions.
“When it’s life and death, we really have to get our act together,” he said.
Warshawski called the acceptance of voluntary youth drug treatment the “best possible situation.” But he said current waits of up to 12 weeks for treatment beds for youth in B.C. is “scandalous.”
He said there is little geographical co-ordination between health officials about available beds for young people, meaning a teen in Kelowna volunteering for drug treatment could be denied immediate help even if there is an available bed at a facility in North Vancouver or Prince George.
Dr. Alice Virani, B.C.’s top clinical medical ethicist, testified Thursday that many options, including treatment effectiveness and fairness to the patient, must be considered before a youth is committed to secure drug treatment.
“It’s never undertaken lightly,” she said. “In certain circumstances, secure care might be justified.”
Virani said youth treatment for eating disorders in B.C. involves placing young people in secure care.
Former B.C. provincial health officer Dr. Perry Kendall was also scheduled to testify later at the inquest, which is coming to a close after hearing from more than 40 witnesses over eight days.