'It keeps calling my name': Fentanyl overdose in B.C. rehab centre prompts coroner's inquest

Brandon Jansen smiled for his mother's camera, but he was suffering badly his third day in rehab.

"I'm struggling.I can't hold it," Michelle Jansen remembers her 20-year-old son telling her when she visited him on March 6 at the Sunshine Coast Health Centre in Powell River, B.C.

"Brandon says, 'It keeps calling my name,' while we were out for breakfast."

She says she met with the medical team and said: "Look, you have to do something ... He can't be left alone.He's in a very dangerous period.'"

Little did she know how dangerous.

Hours later, he'd be dead of a fentanyl overdose in his room.

Most vulnerable after detox

Addicts are most vulnerable to overdose after a period of abstinence, known as detox, because their tolerance goes way down, experts say.

In Brandon's case, he was unable to continue taking Suboxone, which had helped him stay clean for two months prior to starting rehab. Although the doctor at Sunshine Coast Health Centre had the appropriate training, the province had not yet granted him the required exemption to prescribe the drug.

The pills had kept Brandon's cravings for fentanyl at bay and prevented withdrawal symptoms.

Hours after his mother's visit, he was waiting outside for a drug dealer, according to text messages on his cellphone.

"He should be any second," texted a fellow patient, at 1 a.m. on March 7.

"The text messages show the chain of communication between Brandon and this other patient who facilitated the drugs to come in," said Michelle Jansen, who has her son's phone.

Brandon, according to his texts, eventually got tired of waiting outside, and told his friend to send the guy straight to his room.

Drugs delivered, texts say

"The drugs were dropped off to him ...and that was at 2:15 a.m.," his mother said. "At 2:45 a.m., he dropped to the floor."

Brandon's last text read, "Just met him."

He died during his 11th attempt to kick fentanyl, the extremely potent opioid that has killed hundreds of Canadians in the past two years and triggered a public health emergency in B.C. Home-made versions of the powerful painkiller are even deadlier and are showing up across the country.

As is often the case, Brandon's addiction started with a prescription for painkillers after surgery and escalated to street drugs.

The first relapse after detoxing is often deadly, says Dr. Keith Ahamad, who co-authored a recent report urging increased access to Suboxone, calling it "critically underutilized" in the fight against fentanyl overdoses.

The report says the best medical evidence suggests all opioid addicts should be prescribed Suboxone or methadone after detox to prevent relapse.

"There's something about the opioid-addicted brain it's very difficult to stay abstinent and safe without being on long-term medication," said Ahamad, who routinely prescribes Suboxone to his patients at St. Paul's Hospital in Vancouver.

Dangers of relapsing

He says too many addicts are unaware of the dangers of relapsing after a period of abstinence.

"They lose their tolerance to opioids, then they are discharged back to the streets, and the vast majority relapse. And that, coupled with the potency of illicit fentanyl, [means]many are overdosing and dying."

Brandon died four months before B.C. lifted the restrictions that required special training and an exemption to prescribe Suboxone.

Now, any physician in the province can prescribe the drug, which is considered six times safer than methadone.

"The coroner told me herself that when Brandon passed away, he didn't have that tolerance," Michelle Jansen said, "so what he would have considered a normal dose was enough to kill him."

The B.C. coroner's office hasn't made an announcement, but Jansen says she's been notified there will be a week-long public inquest into her son's death beginning in January.

"It's amazing because things will change for other people, other kids, things that should have been put in place years ago," she said, holding back tears.

$200,000 on rehab

She says she spent more than $200,000 on Brandon's recovery at several private and public treatment centres and that he told her drugs were easy to score at every one of them.

"He would say, 'There's heroin available, fentanyl available, cocaine, marijuana,'" she said. "And I still lost my son in a facility that touts itself as being one of the best."

The Sunshine Coast Health Centre calls itself "Canada's leader in men's treatment" on its YouTube channel and has been featured on Intervention Canada, a reality TV show about addiction.

"We have had only one critical incident in the last 12 years," owner Melanie JordanAlsager said in a statement to CBC News.

Citing privacy laws, the Sunshine Coast Health Centre wouldn't answer questions about Brandon's death or even confirm he'd stayed there.

"Sunshine Coast Health Centre is ... in full compliance with our provincial regulation at all times and we take that requirement very seriously ... our evidence-based programming and 24-hour staffing meet the highest standards."

Alsager says the facility's doctor took the training required to prescribe Suboxone and methadone more than a year ago, but after several delays, only received his exemption in July, just a few days before the exemption requirement was scrapped in B.C.

She's "thrilled" every doctor in the province can now prescribe Suboxone.

"We firmly believe Suboxone protects people in early recovery from the intense cravings that can lead to an impulsive relapse resulting in death."

Rehab centre welcomes inquest

She also said her facility "is in no way reluctant to be participating in the BC Coroner's inquest designed to bring attention to the devastating effects of fentanyl on the lives of British Columbians."

Michelle Jansen and her youngest son Nick, 19, have become outspoken critics of B.C.'s response to the fentanyl crisis and launched the Brandon Jansen Foundation to fight for better access to addiction treatment.

Nick, who also lost his girlfriend to a fentanyl overdose last month in Port Moody, B.C., says he was relieved when he learned there will be an inquest.

"[Brandon] said, 'This is taking me I am no match for this drug.It's horrible, and I need help,' and no treatment was able to give him the help he needed."

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