Drug death ‘didn’t need to happen’
Treatment centre writes Wesley's Rule as lack of staff blamed for tragedy
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Hey there, time traveller!
This article was published 10/12/2016 (2360 days ago), so information in it may no longer be current.
Two of Winnipeg’s most important advocates for our most vulnerable people lined up at city hall this week in a way we normally associate with their homeless and often substance-addicted clients.
With their hands out.
Siloam Mission was asking for $2 million. Main Street Project, which provides the drug treatment Siloam doesn’t, was all but begging for $70,000 more.
“That shouldn’t have happened. And it would not have happened if we had had the proper staffing in that facility. That’s my firm belief.”
— Rick Lees, Main Street Project executive director on the overdose death of 25-year-old Wesley Elwick while in the facility’s care
By comparison, the facility once known callously as “the drunk tank” was asking for spare change; a mere pittance of an increase to the city’s long-standing allotment of $96,000 toward Main Street Project’s 34-bed Mainstay Residence. But Thursday, when the shelter’s executive director, Rick Lees, spoke in front of Mayor Brian Bowman and his executive policy committee members, he wanted to stress why the money is so desperately needed in a way they would understand not just as politicians, but as people.
And particularly as parents.
Lees wanted to tell them Wesley’s story, and he did, in what should have profoundly moved our elected representatives. Wesley Elwick was a 25-year-old man from suburban Winnipeg who accidentally overdosed on fentanyl last month while in Main Street Project’s care. He was a young man who wanted to live, and arguably, might not have died if Main Street Project’s Mainstay Residence had enough money — that extra $70,000 — to bring shift staffing levels from one case worker per shift, to at least two people on duty for the 34 residents.
“That shouldn’t have happened,” Lees told me later, referring to the way Wesley died. “And it would not have happened if we had had the proper staffing in that facility. That’s my firm belief.”
Although, as I listened to Lees, and the story unfolded, it wasn’t necessarily as simple as Main Street Project being underfunded by the city and as a result understaffed.
“Wesley was a special case for us,” Lees said after his city hall presentation. “He was young. He was eager. He was determined.”
His obituary suggested he was special in many other ways to many other people.
He “grew up in a loving and caring family,” it said.
“As a little boy, he would play with action figures with his cousin, Nicholas, giggling and laughing for hours. He attended Glenwood Elementary, Laidaw and Shaftesbury senior secondary schools, often being an honour student. Wesley excelled in everything he put his mind to; especially in the sports of hockey, baseball and soccer, playing on numerous community and provincial teams. In his early teen years, his passion was the production of amateur films that were entertaining to all who viewed them. He was a loving son, loving his family dearly. Wesley’s largest battle in life was with addiction, and this is the one area in his life he was unable to conquer though he tried valiantly.”
It was in the course of that battle that Wesley was initially taken to Main Street Project by police, and ultimately embraced by counsellors and the men’s detoxification unit. Wesley’s first detox attempt lasted five days.
“Wesley tried again,” Lees said, “and he completed a 10-day detoxification.”
Ironically, that may have left Wesley more vulnerable than ever.
“The danger of this process is when people are clean for 10 days, their resistance to the drugs they used to use drops. So they’re at high risk if they go back to using. Meaning, if they go back to take the dose they used to take, it can overdose them. So they’re at a critical point to their journey of treatment. And, of course, it’s risky because there’s sometimes a gap between detoxification and stabilization and their being able to get into a treatment program because the waiting lists are long.”
In Wesley’s case, after he completed the program in late October, Main Street Project found him one of the 34 beds in their Mainstay Residence, which is in the same complex as the detox unit.
Lees said they wanted to hang onto Wesley until they could find him continuing treatment elsewhere.
“So Wesley got settled into the room,” Lees said, even though, because of what he referred to again as low staffing levels, Main Street Project “didn’t really do a proper transition of care.”
No sooner had Wesley settled into that room on Oct. 28, that Friday before Halloween Monday, then Wesley disappeared from Main Street Project and into that “gap” Lees had alluded to; that dangerous gap between detoxification and stabilization.
Wesley had headed out the door and onto the street where he quickly found a drug dealer. Later that Friday night at Portage Place he would overdose on fentanyl. Paramedics would save his life, and he would spend the weekend on a ventilator in Health Sciences Centre’s intensive care unit.
“Because we’re so short-staffed in Mainstay,” Lees said again, “there was no ability for anyone to follow up, and we were not even aware — other than we got a phone call on the Sunday from Health Sciences Centre, saying, “Does Wesley live at the Main Stay residence? Because he’s here with us.’”
“Wesley was released from the hospital on Monday and found his way back to us,” Lees said. “Which, again, if we had the staff, we would also take one of our vans to pick him up and return him here to us.”
Instead, he may have arrived in a cab on his own.
A family member told me his parents had learned Wesley was at HSC and told staff there they didn’t want him released. Instead, the family member said, the hospital discharged him alone into a taxi Monday, Oct. 31. Lees said the lone case worker on duty at Mainstay Residence when Wesley returned had no knowledge of what had happened to the young man that weekend. There was something else the case worker didn’t know. By the time Wesley returned that on Halloween night he had already met with a merchant of death, disguised as a simple drug dealer. Wesley was last seen around 8 p.m. entering his room at Mainstay.
The next day he was found dead at the foot of his bed, on the floor where he had dropped from overdosing on fentalnyl, or a drug laced with the deadly opiate that is claiming so many young lives across the country.
Again, Lees referenced the low staffing levels at Mainstay.
“If we had two staff on, the normal process would be to do a debrief with the client. There would be room checks to make sure that client was safe. But because we only had one individual on, it’s impossible to do room checks on 34 individuals.”
If Rick Lees was testifying at an inquest — which I would hope the province’s chief medical officer will call — I expect lawyers would have several questions for him, and others in charge at Main Street Project that go beyond the lack of staffing to their core responsibility of harm reduction for some of the city’s most vulnerable citizens.
Lees said as much when we spoke.
“Certainly, had the system of support been in place in many places — not just Main Street Project. But had there been a proper chain of support and transfer of care between Health Sciences Centre and Main Street Project, this didn’t need to happen.”
Lees suggested Main Street Project has already learned something important from what happened and is changing protocols for the better.
“We’re now in the process of writing Wesley’s Rule.”
It will involve the formal hand-off of care between one program and another that was missing in Wesley’s case.
A way of closing that “gap” in his treatment.
“So this doesn’t happen again.”
Oh, as for Main Street Project’s ask of spare change from the city, it didn’t happen.
Maybe that means that some of us will have to step up instead, this Christmas, and give to Main Street Project in Wesley’s memory. And so many others who have gone before him.
Updated on Saturday, December 10, 2016 3:35 PM CST: Headline changed.