British Columbia

Doctors struggling to cope with growing number of overdose patients with brain damage

Doctors at St. Paul's Hospital, ground zero for the opioid crisis, are seeing 'catastrophic brain injuries from fentanyl overdoses' that are leading to long-term health issues.

St. Paul's Hospital doctors see 'catastrophic brain injuries from fentanyl overdoses'

An unprotected, used needle sits on a metal grate at Carrall and Hastings streets, around the corner from the overdose treatment facility set up at 58 West Hastings St. on Monday. (Rafferty Baker/CBC)

As the number of drug overdoses continues to rise in B.C., doctors are struggling to cope with the increasing number of patients facing irreversible brain damage and other long-term health issues. 

Since January, more than 6,000 patients have ended up in Vancouver-area emergency departments because of drug overdoses.

The majority of patients are released after a few hours but about nine per cent are admitted to hospital for longer term care.

Dr. Del Dorscheid, a critical care doctor in the intensive care unit at St. Paul's Hospital, describe the "catastrophic brain injuries from fentanyl overdoses" that he encounters on a daily basis in his ward.

'Catastrophic' brain damage

"If you don't have enough blood supply, all your organs will be damaged," Dr. Dorscheid said. "The brain, as soon as there is not enough oxygen, starts to have irreparable damage happen. And that's really what we're seeing with all the fentanyl overdoses."

There are no statistics on the exact numbers of people facing long-term health consequences from drug overdoses but, anecdotally, Dr. Dorscheid said it is an increasingly prevalent occurrence.

Today, three of his patients are in the ICU because of drug overdoses. Last Wednesday, after a spike in overdoses when social assistance cheques came out, six patients were admitted on the same day.

Dr. Dorscheid estimated that 90 per cent of patients in the ICU because of a drug overdose have significant brain damage. The care they require is overwhelming, he said.

"We have more patients than we are staffed for," Dr. Dorscheid said. "If this keeps going on as it is, we will eventually run out of room in our acute care facilities."

Most of the patients will never fully recover, he said, and will either end up in a long-term care program in a hospital or in a nursing home.

Overdose deaths are one of the most visible forms of addiction but they are not the only one, says Dr. Keith Ahamad. (Gian-Paolo Mendoza/CBC News)

Outside the ICU

Dr. Keith Ahamad, an addiction physician at St. Paul's Hospital who also works in one of the mobile medical units in Vancouver, said it is not just those in intensive care who face long term health consequences from overdosing.

"What we're seeing in the ICU at St. Paul's is people who have major brain damage but there will be people who will have some damage and not be evaluated," Dr. Ahamad said.

"I see so many people in my addiction clinic that have cognitive impairment from multiple overdoses."

Overdose deaths gets more attention,  Dr. Ahamad said, because it is such a visible, extreme consequence of addiction but it is not the only one.

"What we need to start talking about too is that, with untreated addiction, there are so many other consequences like long term health issues," he said.

Annabel Mead, director of the St. Paul's Hospital Goldcorp addiction medicine fellowship and addiction physician. (Providence Health Care)

Dr. Annabel Mead, addiction physician and director of an addiction fellowship program at St. Paul's, said that even when someone seemingly recovers from an overdose there may still be lingering medical effects. 

"Someone can recover from their overdose but they may have long-term cognitive deficiencies such as poor short-term memory and poor cognitive functioning," Mead said.

This can show up as difficulty with decision making or learning new skills, for example, both of which can hinder addiction recovery. 

"From the addiction medicine physician point of view, that means they can have a poorer outcome with their addiction treatment going forward," Dr. Mead said.