It’s been three years since Valerie Wilson’s son suffered a brain injury following a drug overdose.
The Port Moody mother calls her son “fearless”. He was an ironworker by trade who taught himself how to ride a two-wheel bike as a toddler.
But the overdose affected his sense of balance, speech, and temperament, Wilson said, leaving him unable to pursue his former career and some of his favourite pastimes.
“He used to love high places. Now he has a fear of heights because he tends to fall over,” she said. “He lashes out at people but without the intent to be harmful — he’ll get incredibly angry about things that make no sense to be angry about.”
In the past year, B.C. has successfully brought overdose deaths down to the lowest level in years.
But medical experts and advocates say more needs to be done for survivors, who are sometimes left with brain damage that can worsen underlying addiction and substance use disorders.
Janelle Breese-Biagioni is a registered counsellor and the CEO of the Constable Gerald Breese Centre for Traumatic Life Losses, a charity she founded 30 years ago in memory of her late first husband, an RCMP officer who suffered a traumatic brain injury.
She said brain injuries, which can worsen the risk of substance use, depression or criminality, are an under-examined part of the overdose crisis that killed over 1,300 British Columbians last year.
“If we don’t include brain injury in this conversation, we will never have a 100-per-cent solution to the problem,” said Breese-Biagioni.
The province has said there were 446 fentanyl-related deaths between January and June of this year, compared to 1,334 for the entirety of 2018. This June saw the lowest monthly number of fentanyl-related deaths since September 2016, according to the B.C. Coroners Service.
But Dr. Delbert Dorscheid, a physician and researcher at St. Paul’s Hospital in Vancouver, said the number of people he sees with traumatic brain injuries has not been declining.
Fentanyl, the cause of the majority of illicit drug deaths in B.C., can interrupt blood and oxygen flow the brain.
He says provincial and federal governments do not track the prevalence of acquired brain injuries resulting from overdoses, the impacts of which range from mood swings to memory loss to paralysis.
“They’re not feel-good stories, and they’re not stories the politicians want to promote,” he said. “It’s making the whole topic so black and white, life and death. But in between there’s a lot of grey. We are just not acknowledging the grey.”
Dr. Perry Kendall, the co-interim executive director at the B.C. Centre on Substance Use, speculates the number brain injuries caused by an overdose is “easily in the high hundreds.”
He says those impacted are often stigmatized for their substance use and may have had negative experiences in the health-care system, which he believes is partly why the issue hasn’t been addressed.
“Those who use drugs and are admitted to hospital often can’t wait to get out. They’re not having the best experience with health-care providers,” he said. “We kind of blame people for the symptoms of their illnesses.”
Breese-Biagioni said the impact of brain injuries can trap patients in a “vicious cycle” by worsening the symptoms of underlying mental health and substance use disorders.
She said current funding for counselling for affected persons only covers eight sessions, but she considers the minimum should be a full two years.
Debbie Dee, the executive director of the Powell River Brain Injury Society, has sponsored a motion at her town council to ask the Union of B.C. Municipalities to recommend adding brain injuries to the name and mandate of the provincial Ministry of Mental Health and Addictions.
She said it currently straddles so many ministries and mandates that action on it is almost impossible.
“Brain injury isn’t a mental health issue. It isn’t a substance use issue. It’s not an inclusion issue,” she said. “Where does it fit? It’s never fit anywhere.”
Dorscheid said improving relations with patients and securing research funding is key to understanding the problem and its extent.
“We would probably be able to reduce the burden of addictive disorders within our society if we found ways to treat people more compassionately and more completely,” he said.
Kendall believes the issue is part of a case for a non-toxic regulated drug supply, which he argues would greatly reduce the risk of overdoses in general.
But one problem Breese-Biagioni identified would not be solved by a safe supply — the situation of people already living with brain injuries, and their families.
Wilson is a member of Moms Stop the Harm, a national coalition of families impacted by the overdose crisis.
She supports implementing a safe drug supply, but says the grief she feels isn’t the same as other members of the group whose loved ones have passed away.
“They’re grieving the death of their children, and I still have mine,” she said. “I feel like a faker in some ways, right? It would be so much worse to lose him. But I still see him struggle. I do still have him, but I don’t.”