Premier pivots on holding youths after overdose; grieving parents struggle with “broken” system

Written By Rob Shaw

When Rachel Staples found her 16-year-old son Elliot Eurchuk dead from a drug overdose in the bedroom of their Victoria home in 2018, she channelled her trauma and grief into becoming an outspoken advocate for change to B.C.’s addictions treatment system.

Staples took her son’s story public to call for more youth treatment resources, as well as the power for doctors to hold severely drug-addicted youth in hospital involuntarily after an overdose for several days to stabilize.

“I just feel like, if he could have been in the right place, with the right people, even if it was against his will, he might be here today.”

Rachel Staples

“My biggest regret, having lost my beautiful son, is that I feel like I didn’t do enough,” Staples said in an interview.

“He would have hated me for putting him in there, I know it. And, it’s hard to say whether it would have been successful. But he was such a smart kid, and I know that he knew he wanted to get off of it, because he kept trying. 

“I’ll never know”

“And I just feel like, if he could have been in the right place, with the right people, even if it was against his will, he might be here today. But I’ll never know. I’ll never know.”

Elliot had been using opioids for some time before his death, but it wasn’t until he overdosed on cocaine and fentanyl while in hospital for another surgical procedure in 2018 that doctors first learned of his addiction. 

He asked that his parents not be told – part of an agonizing journey Staples and her husband went through in the healthcare system to try and get him help, while also being shut out of information over their son’s condition due to privacy laws.

After Elliot’s death, Premier John Horgan phoned to offer his condolences. It was one in a series of conversations the premier said he had with several parents of youths who’d died during B.C.’s toxic overdose crisis. Many of whom were publicly railing against a provincial treatment system filled with gaps, wait lists, roadblocks and inexplicable privacy decisions that prevented the kids from getting the help that might have saved their lives.

Those grieving parents included Kimberly Christianson, whose teenage daughter Chelsea was discharged from hospital after four overdoses without support or her mother even knowing. She suffered a final fatal overdose while on a waitlist for a treatment centre.

Horgan triples down

The premier was moved to action.

What followed was Bill 22 – Mental Health Amendment Act, 2020 – legislation to allow youth to be confined to hospital for up to seven days after an overdose, where they could be stabilized in order to make better decisions about treatment.

It would become the most controversial piece of legislation the Horgan government ever tabled.

Bill 22 divided medical experts, was condemned by Indigenous leaders, helped collapse the power-sharing arrangement between the B.C. Greens and B.C. NDP, and was eventually used by the premier as justification for calling a snap election.

Horgan doubled and tripled down on the idea over the past two years, insisting he’d pass Bill 22 by any means necessary.

“It is coming back, and I wish that it had passed in the last parliament,” Horgan said in 2021, adding he “firmly” believed in the proposal.

Then on May 2, 2022, to the surprise of many, the premier quietly admitted he’d abandoned the legislation.

The original idea behind Bill 22 was simple – hold someone under 19 in hospital after an overdose until they were detoxed and in a better place to decide what to do next, rather than send them back out into a provincial drug treatment system full of wait times, missing services and patchwork treatment options.

“Stabilization care… is intended to protect youth who present in the hospital emergency department in the midst of an overdose and to keep them safe.”

Judy Darcy

Then Minister of Mental Health Judy Darcy tabled the bill June 23, 2020, saying experts were telling her that the emergency measure was vital to ensuring the immediate safety of young people in crisis, so they could one day leave the hospital with a clear plan to access voluntary services.

“Stabilization care under the Mental Health Act is intended to protect youth who present in the hospital emergency department in the midst of an overdose and to keep them safe in a designated stabilization care facility,” Darcy said when introducing the bill in the house.

“It will allow provision of medically necessary health care and observation for the youths to recover from their overdose, and it will allow them to regain their decision-making capacity, which is diminished in the immediate aftermath of an overdose.”

‘Secure care’ concept draws friends and fire

The bill was supposed to bring B.C. in line with every other province in Canada (except Prince Edward Island), which each have some form of law on “secure care” for youth in crisis. In Alberta, for example, a child under the age of 18 can be confined to detox and treatment for up to 15 days if a guardian applies for and obtains the right court orders.

B.C.’s legislation was also based on a pilot project at B.C. Children’s Hospital, and what the government said at the time was advice from “renowned child and youth advocates” – including the chief medical officer of B.C. Children’s Hospital, the head of the pediatrics department at B.C. Children’s Hospital, the chair of B.C.’s Pediatric Society and medical director for children at Interior Health, the Vancouver Aboriginal Child and Family Services Society, and the head of Foundry B.C. youth clinics.

It sounded like a good idea, at the moment.

But then, politically, all hell broke loose. 

Grand Chief Stewart Phillip took one look at Bill 22 and knew it would never fly.

His reasons were deeply personal: Phillip’s son Kenny had died of a carfentanil overdose in 2017, one day after his 42nd birthday. He’d been in and out of treatment, which in a way contributed to his death, said Phillip.

“My son was in treatment for about five or six weeks, and during the course of that time, being a regular drug user, his tolerance levels went down,” Phillip, president of the Union of B.C. Indian Chiefs, said in an interview. “When he went out, the first time he used he OD’d.

“So part of our opposition to Bill 22 was that when you take people out of the drug addiction rhythm so to speak, and their tolerance begins to dissipate, when they go back out and the first thing they do is seek drugs, too often they OD. Whereas if they weren’t taken out of the circuit, if my son had not been in that treatment program for several weeks, his tolerance levels would have been for him normal.”

It may sound odd to oppose a bill designed to help kids fight drug addiction on the grounds that it would make them more vulnerable when they start using again.

But Bill 22 was never designed to give youth addictions treatment. It only “stabilizes” them for up to a week, against their will. Some would go on to treatment. Others may not be ready, given they were involuntarily confined, and then simply begin using again in a weakened state, more susceptible to an overdose.

This was only one of many concerns that quickly emerged about Bill 22 in the days after it was tabled, putting the B.C. government on the defensive.

B.C.’s chief coroner, Lisa Lapointe, slammed the bill within hours of its tabling, saying the prospect of being hospitalized against their will could increase fear and stigma amongst youths and deter them from seeking help in an overdose situation.

“Without an established evidence-based, accessible system of substance-use treatment services, I am concerned there is the potential for serious unintended consequences.”

Lisa Lapointe

“Without an established evidence-based, accessible system of substance-use treatment services, I am concerned there is the potential for serious unintended consequences as a result of these legislative amendments, including the potential for an increase in fatalities,” said Lapointe.

Opponents say involuntary aspect “punitive”

B.C.’s Children’s Representative, the B.C. Civil Liberties Association, B.C.’s Ombudsperson, the B.C. Centre on Substance Use, Pivot Legal, the Harm Reduction Nurses Association, B.C.’s Human Rights Commissioner and multiple First Nations leadership groups also expressed immediate opposition.

Some said it was an overreach by the government to hold children against their will without more proven evidence it would improve their health outcomes. 

Children’s Representative Jennifer Charlesworth said it “could add new layers of shame, stigma and fear as many young people experience involuntary stabilization as punitive” while adding it lacked safeguards like the right to an independent review and “could further alienate young people from their families.”

Overall, adding involuntary care without adequate investments in actual substance use services, treatments and supports was a failure by the province, added Charlesworth.

“The moment you talk about taking people into custody, by force, it brings back that whole trauma about residential school in terms of, ‘Oh no it’s happening again.'”

Grand Chief Phillip

First Nations leaders said there would be a disproportionate impact on Indigenous youth, and it was unacceptable for the state to swoop in and seize Indigenous children against their will given the colonial history of the province having done similar things in the past.

“The moment you talk about taking people into custody, by force, it brings back that whole trauma about residential school in terms of oh no it’s happening again, our children are being scooped up off the streets and incarcerated and held for an indeterminate amount of time,” said Phillip.

“The approach to opioids and the drug addiction crisis in our world has been far more broad-based and holistic, and that was viewed as a non-starter. All you do is further traumatize people.”

Government pauses legislation

The immense blowback caught the B.C. government, and Horgan, by surprise.

In response, Darcy announced Bill 22 would not pass in the spring 2020 session of the legislature. Instead, the government would do more consultation and leave the bill on the order paper for a vote that fall.

But when fall came around, senior B.C. NDP strategists were urging Horgan to call a snap election. The premier had enormously high personal popularity numbers, and the public was distracted due to the COVID-19 pandemic.

The B.C. Greens had already told the NDP they would not support Bill 22 – meaning the government did not have the number of votes required to pass it into law that fall like Horgan had planned.

Despite that, B.C. Green leader Sonia Furstenau met with Horgan on Sept. 18, 2021, to try and urge him to stick with the Confidence and Supply Agreement that gave the B.C. NDP minority government power.

Horgan, though, had brought his own list of items he was angry about in the partnership, and Bill 22 was high on the list.

“(Horgan) said, ‘How could you possibly be opposed to this bill?’ And I laid out again… the really significant concerns.”

Sonia Furstenau

“He was going through the list of things, and he landed on this one,” said Furstenau. “He said how could you possibly be opposed to this bill? And I laid out again… the really significant concerns.”

Three days later, Horgan called the early election.

He cited the need for a strong majority to rebuild the province from the COVID-19 pandemic, and a breakdown in the relationship with the B.C. Greens over legislation like Bill 22.

The bill that broke the camel’s back

“One that was a concern to me was one to do with mental health, and whether a medical practitioner or a doctor could keep a minor, a child, who had been admitted with an overdose under observation for a week,” said Horgan, on the day he called the snap vote.

“That was what we were asking to do. And there were people in the legislature that did not support that and having met with parents who have lost children, I was not prepared to accept that. But it seemed OK to others in the legislature and I’ll leave it at that.

“Having met with parents who have lost children, I was not prepared to accept” defeat of Bill 22.

John Horgan

“But that was really the deciding issue to me.”

Horgan would go on to speak about the election’s “deciding issue” of Bill 22 several times.

There was no mention of the growing list of watchdogs, community groups and First Nations opposed to the idea. 

Horgan pinned it all on the B.C. Greens.

Horgan led his party to a decisive victory in the election and was returned to Victoria with a large majority.

Over the next two years, he would repeatedly mention Bill 22’s imminent return, saying it was slated to be tabled again after consultation and this time he had the votes to turn it into law.

But in the background, the concerns raised by Indigenous leaders had taken root in Horgan’s cabinet.

Since the bill’s original drafting, the discovery of suspected unmarked graves at residential schools in B.C. had highlighted once again the province’s shameful history of seizing Indigenous children from their homes and forcing them into state-run programs.

At the same time, the government had moved its Declaration on the Rights of Indigenous Peoples law into action in every ministry with the promise it would not make policy without consultation and consent of Indigenous leaders.

Indigenous concerns halt bill

And, in early 2021, former children’s representative Mary Ellen Turpel-Lafond released a report outlining systemic racism issues faced by Indigenous peoples in the healthcare system.

The Indigenous opposition to Bill 22 took on a different, stronger, light amid all of those developments.

It wasn’t tenable to resurrect the legislation without First Nations support.

When Horgan abruptly announced the bill was abandoned in May 2022, he did so at a press conference surrounded by Indigenous, black, and racialized community leaders who were present for another announcement on anti-racism legislation designed to root out the systemic harm in government services. 

Many there felt Bill 22 would contribute to systemic racism.

Horgan cited one of the speakers when explaining his decision to cancel Bill 22, saying government had got the process wrong and that process mattered.

“Did I want to see the legislation come forward? Yes I did,” Horgan said.

“I was given evidence that that wouldn’t be the best way forward. And as my mom raised me, look at the new evidence and take your direction from that, don’t hold fast to yesterday’s ideas, hold fast to the confidence you should have to the people who are working on this each and every day. And that’s where we’re going.”

Reaction to the rise, fall, and political football that became Bill 22 was mixed.

Furstenau heard the news and said she was “speechless.”

The “evidence” against Bill 22 that Horgan cited had been there the whole time, she said.

To the B.C. Greens, Bill 22 had simply been a convenient excuse by a premier looking to create the conflict necessary to call an opportunistic early election to secure a majority government.

The fact the Greens were blamed for it by a premier who never acknowledged any of the other opposition until the end, was astounding, said Furstenau.

“It was a rewriting of history,” she said. 

“There’s an abundance of reasons why people were just raising this alarm about this bill, and for the premier to frame it about how we didn’t care about kids was just astonishing.”

Indigenous leaders are glad the bill has been cancelled, but are aware the premier used it for his own political gain.

“I think that was political opportunism,” said Phillip.

“I think that the confidence and supply agreement was beginning to tatter and I think this was a prime opportunity to dump it and that’s what happened.

“I don’t for a moment blame the Greens. I think the Greens were very much of the same mind in regard to the approaches to the opioids crisis, as opposed to involuntary detention of young people.”

B.C.’s Human Rights Commissioner, Kasari Govender, praised the decision.

“Even if it’s well-intentioned to save children’s lives, we have to be aware of the ongoing impact of state intervention in Indigenous families.”

Kasari Govender

“We can’t continue incarcerating and detaining children within our system, without truly having a decolonized system,” she said. “This is just replicating the ways in which colonial society has controlled Indigenous families, Indigenous children, and Indigenous parents. Even if it’s well-intentioned to save children’s lives, we have to be aware of the ongoing impact of state intervention in Indigenous families.”

Mixed feelings

For Staples, who continues to push for meetings with Horgan and current Mental Health Minister Sheila Malcomson, the end of Bill 22 brought mixed feelings.

“I do understand why the bill was kiboshed with regard to the Indigenous communities,” she said.

“I completely understand given what we have learned about residential schools and having a child under the government’s care and telling them that he has to be forced to stay in the hospital. I get it.”

But the current system remains broken, said Staples. A lack of beds, enormous wait times, privacy laws that lock out parents, and kids making decisions about their health in the grips of addiction, is not tenable, she said. 

More than 142 youths under the age of 19 have died from toxic drugs since 2012, according to the B.C. Coroners Service. While it’s a small percentage of the 11,085 overdose deaths, it’s also the most vulnerable population.

Staples now meets regularly with a group of other women who have lost their sons to the overdose crisis and want government action.

If Horgan wants to abandon Bill 22, he should come up with other fixes to the system, she said.

“We did try and do everything within our power to save our son,” said Staples.

“Unfortunately, it caused him more trauma than good and, you know, I guess the opposition to that would say that’s exactly what you’re doing by forcing a child into treatment against their will, is you’re creating trauma. 

“But there has to be something that a parent can do without watching their child self-destruct.”