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How many drug users do OD have brain damage? Doctors say Canada needs data



VANCOUVER – Drinking drug Dayton Wilson ended when he overdosed on heroin mixed with fentanyl, but being able to walk and talk normally was also part of his past when he struggled with brain damage from drugs that were associated with thousands of deaths.

Wilson, 24, used drugs for the last time in August 2016 in Downtown Eastside Vancouver, according to his mother, but he remembered nothing about the day he was taken to the hospital.

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

The latest figures available from the Canadian Public Health Agency say more than 9,000 people have fatal overdoses across the country between January 2016 and June 2018. British Columbia's coronary services account for nearly a third of those deaths.

But there are no comprehensive statistics for people who survived the effects of opioids that damage the brain. Doctors say that information is very important to understand the magnitude of victims of "forgotten" opioid crises and to provide them with care and resources so that they can function as functionally as possible.

More than two years after speech, physical and occupational therapy, Wilson spoke haltingly and was difficult to understand. He stopped before answering questions about what he might remember after he was transferred to St. Hospital. Paul by ambulance.

"I don't remember this, but I didn't breathe for about five minutes," he said about how long his brain was believed to have been deprived of oxygen.

While speaking can be frustrating, what he regrets the most is not being able to rap, one of his passions.

"The balance is rather difficult for me now," he said, adding he sometimes fell backwards and hit his head.

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

"I really like the person who made me," he said of his trials. "I just don't like what happened to me."

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

The impact of the final overdose is very heavy for the family.

"He tried to eat and it was like watching a severe Parkinson's patient," Wilson said when he saw his son in the hospital. "He was trembling and couldn't keep food in his fork."

Wilson said there was little awareness of the consequences of brain injury in those who survived the opioid crisis.

"One thing I often hear is, & at least you still have it. & # 39; Often, I like," Yes, actually, no, I don't know. I have a version of it. "

He said his son was an iron worker who would walk along a high steel beam in the air, and now he did not want to go to the edge of the rock on the beach because he might fall.

The Wilson family has tried to find community programs and support groups for him, but the only service available is for people who deal with unrelated problems, including strokes that affect older adults, his mother said.

"He wants to be a contributing member of the community," he said, adding that his son recently got a part-time job as a cleaner in a Kamloops hotel, where he now lives with his father.

"Going to work is important for her pride and now she has this job, where she basically cleans the toilet, she likes it."

Norma McDonald's daughter, Tracey McDonald, now 44, was addicted to prescription opioids for decades after being diagnosed with endometriosis when she was 14 years old. He suffered brain damage after the first and only overdose in July 2017.

"Endometriosis is so painful that he will actually fall to the floor," McDonald said of his daughter, who began "shopping for doctors" for methadone, OxyContin and Percocet, eventually undergoing addiction treatment on the advice of her family doctor.

He relapsed and overdosed, suffered brain damage that had affected his speech and made him dependent on a wheelchair, his mother said.

"When people heard that it was caused by a fentanyl overdose, he wrote quite a lot and that was very unfortunate," McDonald said of her daughter, who lives with her parents.

Adam Peets, a doctor in the intensive care unit at St. Hospital Paul, where Wilson was initially treated, said brain cells can be affected in just 30 seconds after a person overdoses and the level of damage can vary from mild to severe. .

An estimated 25 to 33 percent of patients are admitted to the ICU because of complications from increasingly powerful drugs such as fentanyl and carfentanil, but there is currently no way to collect that information adequately, Peets said.

Electronic health records include the diagnosis of patients at admission, he said.

But some of these people may be diagnosed with shock or something unclear in the emergency room and brain injury will be determined later through laboratory tests later, which are said to be recorded on a separate system.

"It's embarrassing, frankly," Peets said of the lack of data about brain injury caused by overdoses, which he wanted to see traced nationally. "This is something that the entire health care system needs to do to do a better job."

Without data, it is impossible to measure the resources used in hospitals or how the resources in the community can be best utilized, Peets said.

"How can we adjust the way we do business without having the best data to help drive those decisions, such as staffing or going to the government and saying,‘ See how many patients overdose and experience chronic brain injuries. We need to do more primary prevention and secondary prevention or fund post-return rehabilitation. "

St. Paul will be among hospitals in the Vancouver area to launch a new electronic health record management system in 2019 to collect data better but it will not be simplified in all provinces, where many systems are used, he said.

Dr. Patricia Daly, head of the medical health officer from the Vancouver Coastal Health, cited the lack of data regarding brain injury caused by a "tragic" overdose because both patients and their families did not get the support they needed.

"We focus on death but we forget that there are a group of other people who have been negatively affected, some of them very severe."

Nicholas Gnidziejko, operations manager of the clinical administration database for the Canadian Health Information Institute, said national statistics on brain damage associated with the crisis of overdose would require the development of a set of standards to collect data in a consistent and comprehensive manner but no system in any province.

Camille Bains, The Canadian Press


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