Inquest judge calls for more detox beds, flexible treatment

The Manitoba government has been advised to increase help for people with addictions after the overdose death of a homeless man who was turned away from treatment several times.

In a 43-page inquest report, associate chief provincial court Judge Tracey Lord made eight recommendations, including calling for an increase to the number of Rapid Access to Addiction Medicine clinics. She said the RAAM clinic near Health Sciences Centre should be open five days a week and have evening and weekend hours.

Lee Earnshaw, 42, died of an accidental fentanyl and methamphetamine overdose on June 14, 2021, after he sought help several times.

Lord said she hopes the inquest will lead to others being able to access treatment.

“It is abundantly clear the resources available to those requiring publicly funded addiction care are extremely limited when compared to the growing need,” Lord wrote in the report, released on Friday.

“It is also clear the need for help comes at all times of the day and night. When asked for their own recommendations, every witness began by highlighting the need for increased funding in the sphere of addiction treatment.”

The judge said Manitoba Health should pay for opioid replacement therapy for those who can’t afford it, and the number of detox beds and facilities should be increased, especially in northern Manitoba. The government should offer flexible treatment models from bed-based treatment to community options, the judge said.

“While I am unable to say one or even a combination of these recommendations would have prevented Mr. Earnshaw’s death, I am however hopeful that these recommendations will increase the likelihood that someone in (his) circumstances will meet with success when they ask for help.”

Carol Packer, Earnshaw’s sister, who spent months pushing for an inquest before it was called in 2022, said she hopes the government doesn’t wait long before following the recommendations.

“The whole goal is to make change…” Packer said. “We want to see the province move quickly and act on the recommendations. If that happens, it will help families.”

Arlene Last-Kolb has been an advocate for addiction treatment since her son Jessie died from fentanyl more than a decade ago. She said while the inquest report will make a difference, much of it involves what she advised the government when she presented a petition with 5,000 signatures in 2019.

“But what the judge recommends is fantastic. I guess I just want to see it done right away. It is really hard to wait when you know so many are dying.”

Earnshaw was one of 400 confirmed substance-related deaths in Manitoba in 2021. There were 335 deaths in 2020, 151 in 2019, 574 last year and, between January and May this year, 167.

Premier Wab Kinew said “we know that more needs to be done.”

He noted the province has added more RAAM clinics. An additional clinic will be in the renovated Portage Place. He said the province is in the process of passing legislation to open a protective detention facility to hold people under meth psychosis for as long as 72 hours.

“You need to have prevention,” Kinew said. “You need to have treatment, you need to have harm reduction and you need to have enforcement, too.”

“So we’re trying to take action on every step, having more police officers, more recovery beds, harm-reduction interventions, and of course, interventions in education and the justice system, hopefully to prevent future addictions.”

Marion Willis, founder of St. Boniface Street Links, said Earnshaw asked them for help several times, between February to May 2021, but each time they took him to a RAAM clinic or the Main Street Project, he was turned away. Either they were too full, he needed to abstain from drugs for a set period, or they had long waiting lists.

“Every time we listened to him, he asked us to find any way to get him out of the hell he was in,” Willis said. “All he wanted to do was return home to his children and be back in B.C. to be a commercial fisherman to support his children.”

In a statement, Jamil Mahmoud, executive director of the Main Street Project, said they agree with the judge’s recommendations.

Mahmoud said there is a need for accessible and flexible support. Now that the judge has delivered her recommendations, MSP will work on a report detailing the actions it has taken, and will take, to implement the recommendations that apply to its work.

Earnshaw, who was born in Winnipeg and moved to British Columbia, was married and had three children. He injured his hand on the job and was prescribed opioid medication.

He moved back to Manitoba in 2017, and by 2021 he was living in a tent near the Seine River.

“He was just a great person,” Packer said. “He would just light up a room — we all adored him.

“Even in his deepest stages of addiction, his personality was always there.”

The judge also said primary care doctors should provide opioid replacement therapy and she recommended medical students be offered incentives to specialize in addiction treatment. In addition, providers should expand community outreach to help people in all stages of treatment.

kevin.rollason@freepress.mb.ca