No snow fell on Victoria leading up to Christmas 2018.
Yet 21-year-old Michael Mahoney’s body went undiscovered for five days after he overdosed on fentanyl in his pine-green pickup truck, parked in a busy downtown lot on Wharf Street.
There were two parking tickets on the dash when his friend found the truck and opened the door to find that Michael’s eight-year battle with addiction had finally ended – just not the way it should have.
The day before he died, Michael had been approved for treatment at a facility in Burnaby. His mother, Jan Mahoney, had been working with his counsellor at the Victoria Youth Clinic and pushing to get his application approved for months.
She says the system failed her son. And it might be failing hundreds of others.
“It’s devastating,” Mahoney said, sitting at the dining room table in her Saanich home in March. The Hartland Avenue property is secluded, the home perched amidst spring foliage up a winding, newly paved driveway. Shots are fired in the distance – a rifle range only kilometres away.
A stack of papers sits on the table, pages of nauseating red tape detailing the last decade spent trying to save Michael’s life.
“There’s so many places where the system has fallen apart,” she says. “I just don’t think that it should take as long as it took to get somebody into treatment.”
Mahoney looks tired, her hands shaking but her voice solid. She was recently diagnosed with multiple sclerosis after spending months in the hospital for spastic paraplegia.
From her hospital bed, she slogged through the bureaucratic barriers of getting Michael into treatment, making daily phone calls about the progress of his application – all while he descended further into addiction.
|Michael Mahoney was addicted to opioids for most of his short life. He was prescribed oral dilaudid tablets in his early teens and continued to struggle with addiction until he died at 21-years-old just before Christmas, 2018. (Photo/Jan Mahoney)
At 13, Michael was a blonde-haired, blue-eyed choir boy. He was affable, social and outgoing. He performed with the Victoria Children’s Choir and in the Pacific Opera’s production of Magic Flute. He dabbled with the cello and bass. He often requested Aaron Copland, a classical American composer, from the back of his parents’ car. Later, he would pick up DJing.
But at 13, Michael became sick with a viral stomach condition that created intense abdominal pain. He couldn’t eat or go to school. At one point, the Grade 8 student weighed only 90 pounds.
Mahoney says her son’s first experience with an opioid came through the form of a prescription pad. A pain clinic prescribed him a nasal opioid and later, when the pain continued, he was prescribed Dilaudid tablets – opioid analgesics that work in the brain for pain management. The prescriptions went on for months but when the illness ended, so did his “safe” supply.
He told his mom how difficult it was to stop taking them.
Mahoney remembers him telling her, “Mom, those pills were really, really hard to get off of. I think I was addicted.” She wasn’t sure what to think. He was off them now, wasn’t he? And things were better for a while.
Until they weren’t.
Michael was addicted to opioids – an addiction he continued to battle throughout high school – but it was after graduation that everything went south.
|Michael Mahoney spent much of his short life battling an addiction to opioids. His mom, Jan, remembers her son, before addiction, as an outgoing, social and musical child who loved to sing. (Photo/Jan Mahoney)
His mental heath deteriorated rapidly and his addiction to opioids became unmanageable. Michael would be gone for days or weeks at a time and return home to detox. His bedroom was littered with used needles and he was admitted to hospital frequently. He received diagnoses of ADHD, OCD, anxiety and depression – disorders that he self-medicated with opioids and various other drugs.
The right kind of care
Mahoney said the issue was finding a facility or care provider to treat both his addiction and his mental health. Michael was treated by a family doctor, by the hospital, by aid workers and by a counsellor at Foundry Victoria– a youth clinic offering substance use support and counselling.
Overall, she says, his care was disjointed and erratic.
In August 2018, Mahoney began the tiresome task of trying to get Michael into a treatment centre. Her first choice was in Ontario, but it wouldn’t be covered by the provincial government since she hadn’t yet exhausted treatment centres in B.C.
According to experts, the best option for Michael, based on his severe mental health and addiction issues, was a Tier 5 facility that could treat both. The only option was the Burnaby Centre for Mental Health and Addictions, a high-level facility that requires referrals from regional health authorities. Each authority has only a limited number of beds – for Vancouver Island, just 14 beds are available, and the application process is incredibly thorough.
“They’re looking for folks who are going to have a reasonable chance at being successful,” said Kelly Reid, director of mental health and substance use at Island Health. “So we have to be quite clear with the applicants about the nature of treatment and then they have to say: ‘Well I’m ready and I understand what that will be like and I still really want to attend and participate in this service.’”
With limited space available, the facility wants good candidates only – that means clients willing and dedicated to their treatment, with supports ready for them when they complete the six to nine-month program.
“At a Tier 5 level - it’s not a crisis service, there’s an expectation there will be supports in place to continue with their recovery,” said Reid. “The application process is almost a care-planning process.”
But Mahoney says paperwork was stalled moving from the Island Health psychiatric team to the treatment centre. There were requests for a psychiatric evaluation despite the fact that Michael had been evaluated at the downtown youth clinic.
By fall, Mahoney said her son, off and on Suboxone and Methadone, was “like a cadaver.”
“By that point Michael is very ill,” she recalled. “He’s hardly getting out of bed in the morning. He’s not eating…He could die any day, that’s where we were at.
“So here’s a kid with drug issues and mental health issues. He can’t get a psychiatrist, he has no ADHD medication, he has no medication for his anxiety, he’s basically untreated and he’s got a serious addiction to opioids.”
Reid said red tape is a challenge.
|Glen and Jan Mahoney hold an image of their son Michael, who died of an overdose in December after struggling with opioid addiction since age 13, at the downtown Victoria rally in support of the National Day of Action on the Overdose Crisis on April 16. (Nina Grossman/News Staff)
“If you have a really expensive and specialized service, I can appreciate why they want to make sure that everyone who is in every bed is…the top candidate,” he said. “But then the result is… there is a fair bit of process required to ensure that’s the case. Which is a barrier for people. And that’s definitely one of the challenges.”
After voice mails, paperwork and pressure from Mahoney and Michael’s therapist at Foundry Victoria, his application was accepted at the Burnaby centre. Michael overdosed the next day.
A normal kid that struggled
“He obviously went and bought a contaminated Dilaudid which was the pill he had always used from the time he became addicted,” Mahoney said. “And he died of a fentanyl overdose.”
“He was in his truck for five days,” she added. “That was really hard, that someone could die in their vehicle and not be found.”
Since his death, Mahoney and her husband Glen are hoping there could be a BC Coroners inquest – something she said was brought up by the coroner who dealt with Michael’s case.
“She said she’s heard this over and over and over again. That people need treatment, and there’s such a huge delay in [getting] treatment and a lot of times, while people are waiting to get into treatment, they die of overdoses.
“It shouldn’t be like that. It shouldn’t be that hard to get somebody in for treatment.
“People say, ‘You’ve done so much, you’ve worked so hard, you’ve advocated…’ but unfortunately, when you lose a loved one, you go back into your mind and think what did I do wrong here? Maybe I should have been more patient?” she added.
Mahoney believes that if she hadn’t advocated for her son to get into treatment, he never would have gotten a spot.
“And it probably would have been the same outcome. Michael was a normal kid that struggled.”