Sam Darroch has never done drugs, and he cannot imagine what would make a person want to live a life impaired by hash or heroin or fentanyl.
And yet, at some point over the course of the lives of roughly six million Canadians, it isn’t about want — it’s about substance use disorder, about addiction. One expert likens it to brain damage.
That’s how it was for Trevor, the youngest of Darroch’s two boys.
The first time Darroch caught Trevor with drugs, it was 1996. His son was 15 years old, and Darroch called the police in Kitchener, Ont., to “put a scare” in him. It didn’t work.
Darroch says Trevor overdosed on April 20, 2019. He was 37 years old.
“He could have had a whole different life if it hadn’t been for drugs,” says Darroch from his home in Mortlach, Sask.
“I’ve got a boy sitting up on my mantel now in his urn. People just aren’t realizing that that could be them.”
When Trevor died at Warkworth Institution near Campbellford, Ont., he was more than halfway through a two-year, 10-day sentence for dangerous operation of a motor vehicle, operating a motor vehicle while disqualified and two counts of drug trafficking.
But saying that — that Trevor was struggling in prison and incarcerated when he died — makes it easier for people to tune out. Where the opioid crisis has been an election issue, prison reform has not.
A search for “prison” yields nothing in the Liberal platform, a promise to improve rehabilitation programs but axe the needle exchange program from the Conservatives, a promise to address the over-representation of Indigenous and black people in prisons from the NDP and a promise to reinvest in prisoner rehabilitation from the Greens.
Prison reform is rarely an election debate unless — as the federal correctional investigator noted in his last report — it’s part of the politically advantageous “tough on crime” rhetoric that ultimately “led to some poor policy choices grounded more in ideology than in evidence.”
But if Canadians want to address the opioid crisis, which claimed nearly 1,500 lives last year in Ontario alone, they need to pay attention to what’s happening in our prisons, says Dr. Lori Regenstreif, an assistant professor at McMaster University.
“They’re full of people who have drug problems, and those drug problems become unresolved and they go out and don’t do well, they go out and they overdose, they go out and they come back in again,” says Regenstreif, who also works with the rapid access to addiction medicine clinic at St. Joe’s Hospital and the Shelter Health Network.
She provides inpatient addiction services at St. Joe’s and Hamilton Health Sciences as well.
“There are so many cheaper and better ways to look after people with substance use disorders than to incarcerate them.”
There has been “minimal research” done on prison overdoses, according to a 2018 report from Correctional Service Canada (CSC). This despite the fact a Corrections Canada spokesperson said 62 per cent of men entering prison are assessed as “having a history of problematic use of substances.”
That report broke down overdose incidents among those in federal custody for the five years between 2012-13 and 2016-17. It found opioids were the most common culprit and that, by and large, it was men who overdosed. The report also said that in three-quarters of cases, the overdose was not intentional and not deadly. Inmates who were overdosing were predominantly white, between the ages of 25 and 34, housed in medium-security facilities and serving sentences between two and four years in length.
Six prisons were highlighted for having 15 or more overdoses during that five-year time frame. One is Warkworth, where Trevor died. The records indicate the prison saw 11 accidental, non-fatal overdoses, two intentional but non-fatal overdoses, two fatal overdoses and one listed simply as “other.”
But despite the fact that more inmates are accessing opioid substitution therapies (OSTs) like methadone in prison, according to the correctional investigator’s report, only 1,088 inmates were documented as having received OSTs last year.
Two inmates who knew Trevor at Warkworth but did not want to be identified by name for safety reasons told Global News that Trevor — despite multiple overdoses, one of which prompted a stint in segregation shortly before his death — was on a wait list for methadone. As of July 2019, 77 inmates at Warkworth were receiving treatment, while 14 inmates were on a waitlist, according to a Corrections Canada spokesperson.
This infuriates Regenstreif.
“I don’t understand the concept of a wait list,” she says.
Any doctor can prescribe buprenorphine, which is an opioid medication like methadone that’s used to treat addiction. For those who dispense the medication, it’s less restricted than methadone, Regenstreif says, and less dangerous, too.
“There shouldn’t be wait lists at this point in time because we have access to medications that can, in a very timely way — within a day, within hours sometimes — give people back completely a sense of comfort and normality.”
A spokesperson for Corrections Canada did not answer questions about buprenorphine or the wait list for treatment. She said CSC uses “a suite of harm reduction measures” to support offenders including screening and testing, trained peer support, mental health referrals and counselling, as well as overdose prevention services.
Ultimately, Regenstreif says, prison is a “golden opportunity” to help combat the opioid crisis because it is ostensibly a forced abstinence environment, and withdrawal is an ideal time to start someone with opioid use disorder on buprenorphine.
But while that makes prison a good time to help people, she says, it also makes it a dangerous time not to help people.
“The risk is if we don’t treat, people stay in prison, and they’re in withdrawal and they’re craving opioids, and somebody smuggles in a very potent opioid,” Regenstreif says. “After several days of abstinence, they’ve lost their tolerance so their risk of overdosing becomes very high.”
Trevor spent several days in segregation in March 2019 after he took “two hits of shatter” — a very potent form of THC/hash — and overdosed, requiring nine nasal sprays of Narcan and the use of an automated external defibrillator, according to a review of Trevor’s “segregated status” that Darroch shared with Global News.
After that overdose, guards searched his cell and found two “clean jam pack lids that tested for Fentanyl, Heroin, THC and Hash/Mar(ijuana).” Trevor had previously been written up for smoking in his cell and testing positive for THC and amphetamines.
When he got out of segregation, one of two inmates in Warkworth who spoke to Global News on the condition of anonymity says nobody wanted Trevor in the same unit as them because an overdose meant a lockdown, which meant days or weeks without access to a shower or phone privileges.
“He kept on ODing … and they kept on searching (the cells),” the inmate says, so the rest of the men on the unit started “playing doctor.”
“They would slap him in the face and then they would try to put him under the shower (to revive him).”
A spokesperson for CSC said the investigation into Trevor’s death is ongoing but that she could not comment further “as per the Privacy Act.”
This is hard for Darroch to hear. He still doesn’t know much about how Trevor died. The morning after Trevor died, Darroch says he called Warkworth and was told two people had overdosed.
“The other guy made it, and my son didn’t,” he says.
Later, when he talked to the coroner, Darroch says he was told: “Trevor was dead long before the other guy even hollered for help.”
Trevor was born on Oct. 15, 1981. Darroch remembers him as a healthy, active kid with a love for basketball and skateboarding, a “heart of gold” and no shortage of friends. But he was also inscrutable, making it hard for his father to know how to help him.
Trevor was considerate but had no real respect for the law, Darroch says. He was interested in problem-solving but lacked the motivation for anything more involved than a short-term fix, and although he acknowledged his struggle with opioid use, Trevor dismissed methadone treatment as “one drug substituted for another one,” Darroch says. (This, experts like Regenstreif say, is a tough myth to bust).
Trevor was 20 when his parents separated in 2002 and Darroch moved to Saskatchewan. For a while, Trevor stayed with his dad, but that didn’t last. Mortlach, pop. 261, was too quiet for him.
After that, Darroch saw his son less frequently. He talked to him about drugs even less, although news he was still using filtered west. During one visit, Darroch took Trevor on a drive through a part of Kitchener where many people experiencing homelessness and struggling with addiction stayed.
It was meant to be another wake-up call, Darroch says. “I kept hoping for better.”
One of the last conversations Darroch had with his son was a few days before he died. Trevor had a little less than a year to go before his release. He was planning to go back to Saskatchewan.
“He was going to come out here and start all over again,” Darroch says, adding that Trevor seemed to be looking forward to spending time with his step-siblings and his nieces and nephews. Hearing Trevor say that, Darroch started to believe he was finally ready to get help.
For the longest time, Darroch blamed himself.
“I honestly believe you can’t help somebody that doesn’t want to help themselves.”
But Trevor is gone, and Darroch is left wondering if CSC is telling him the full story. He says his conversation with CSC officials gave him the impression that Trevor got the drugs via visitors, but Darroch doesn’t believe that. He’s gone through multiple security checks during visits to his son, and he’s had letters returned to sender with a note they tested positive for trace amounts of fentanyl.
“They should have to force the issue of how the drugs are getting in there,” he says. He wonders if it’s guards “taking it in and selling it.”
“They damn well should have been watching him closer,” he says.
A spokesperson for CSC said she could not comment about specifics pertaining to Trevor’s time in prison.
What’s happening is a “conflict of cultures,” Regenstreif says. Health policy in prison is determined, for the most part, by the correctional ministries overseeing incarceration.
“Their priorities are going to be cost (and) public safety,” she says. “Whereas a health entity would be much more interested in the positive outcomes, the health outcomes, and the morbidity and mortality rates.”
A corrections-focused health approach isn’t necessarily right, Regenstreif says.
“Putting more machinery in to try to detect a couple grains of salt that are somehow being smuggled into a big building is probably a big waste of time when treating people for their cravings and for their drive to use this illegal substance would actually get you a lot more mileage.”
And yet, barriers remain.
The West Coast Prison Justice Society filed a human rights complaint against CSC last year, alleging inmates who have opioid use disorder weren’t getting the treatment they need and were living in fear of fatally overdosing like Trevor.
The complaint is ongoing, said Nicole Kief, a legal advocate with the society, via email, adding that she couldn’t say much more at this time. She did, however, note that the society has received far fewer complaints from federal inmates in B.C. since lodging the complaint.
Still, she wrote: “We continue to have concerns, including about how this issue is being addressed in other provinces where there is no (Prisoners’ Legal Services) equivalent.”
For Darroch, the conversation about his son’s addiction is hard. But for Trevor, he’ll have it.
“It’s not going to bring him back but it could save somebody else.”
There haven’t been that many overdoses since Trevor died, says one of the two inmates in Warkworth who spoke to Global News. That doesn’t mean drugs have stopped coming in, he says, nor does it mean fewer people are using.
He thinks everyone got nervous after Trevor died so now they’re a little more cautious.
“They’re cutting it more to not make it so deadly.”