Tuesday, May 31, 2011 – Globe and Mail
ANNA MEHLER PAPERNY
She was a 48-year-old mother and former nurse, receiving disability payments for back pain.
He was a fearless 19-year-old known for befriending everyone, who bounced from high school to temp jobs, from one couch to another when he and his dad argued.
They died days apart, in the same apartment, overdosed on drugs.
She had prescriptions – for the OxyContin toxicologists say caused his death, and the cocktail of antidepressants and sedatives they say precipitated hers.
He did not.
An inquest starting in Brockville this week into the 2008 deaths of Donna Bertrand and Dustin King will try to piece together not how they died so much as how to prevent deaths like theirs.
The drugs believed to have played a primary role are legal medications prescribed by doctors in increasing numbers: Canada is second only to the United States among pill-popping nations. Mel Kahan calls it an “iatrogenic” epidemic – a medical crisis caused by the medical profession.
Dr. Kahan, an addictions specialist with the University of Toronto’s Department of Family and Community Medicine, is among more than a dozen witnesses who will testify at the inquest. He’s prepared a lengthy brief on the case, outlining evidence from records, interviews and toxicologists’ reports into the two deaths.
He said in an interview that Alan Redekopp, the Brockville doctor who, by the end of Ms. Bertrand’s life, was prescribing her about 1,000 milligrams a day of oxycodone, was simply a doctor who wanted to ease his patient’s pain the best way he knew how.
A receptionist from Dr. Redekopp’s clinic said on Friday he had no desire to comment for this story.
Brenda Toupin-Wiles had never heard of OxyContin before she got a phone call on Nov. 21, 2008.
It was her parents. Her oldest son was dead. His body was found, cold, on the couch he’d passed out on hours earlier in Ms. Bertrand’s apartment after a long night of partying.
“I don’t want to say he was a drug addict,” Ms. Toupin-Wiles said. “He wasn’t the kind of person to get up and get a fix.”
But in Brockville, a city of 22,000 people about 100 kilometres southwest of Ottawa, OxyContin is all too easily available.
David North, executive director of TriCounty Addiction Services, said the proportion of addicts in the area struggling with prescription drugs has almost tripled in the past five years. The majority of that increase is among people under 25.
“Around here,” said Mr. King’s friend, Melissa Anderson, “a lot of kids do OxyContins. … It’s hard not to know somebody” who’s selling.
When she got the news of Mr. King’s death, she was familiar with the grey-brick building at 89 King St. W. where her best friend watched paramedics wheel Mr. King out on a stretcher.
“As far as I know, it was called the crack shack.” And the kids who hung out there, she said, were there for drugs.
Dan King isn’t sure when his older brother, Dustin, met Ms. Bertrand, although he remembers seeing her at their dad’s house, where she would come by for a beer.
“She hardly talked. She was hardly ever awake. She’d sit down on the couch and fall asleep almost instantly.”
But by November, 2008, Dustin was at her King Street apartment two or three times a week. He was there to buy pills, Dan said, but had started taking Oxy recreationally before that.
Dr. Kahan said that to Dr. Redekopp, Ms. Bertrand was a patient in pain who kept misplacing her scrip.
The former Kemptville District Hospital nurse from North Augusta, a small community just north of Brockville, had been seeing him for about two years, after her previous doctor died.
Ms. Bertrand would tell Dr. Redekopp “that the medications were stolen or something of that sort, and then he would ask for confirmation through a police record,” Dr. Kahan said. “But that’s very easy to get: All you do is call the police and say, ‘My medications were stolen.’ ”
So he kept refilling her Oxycontin prescription – close to 10 times what’s considered a “watchful dose,” the level at which red flags should be raised, Dr. Kahan said.
“If you’re approaching that dose, you should ask, ‘Does the patient really need that much?’ ”
But her doctor didn’t ask, Dr. Kahan said, because doctors aren’t routinely trained to know when that point has been reached.
Last November, Ontario’s College of Physicians and Surgeons restricted Dr. Redekopp’s licence, forbidding him from issuing new prescriptions, or renewing old ones, for narcotics or benzodiazepines (a type of sedative). He faces a disciplinary hearing next fall in response to a complaint alleging professional misconduct.
Dr. Redekopp stopped writing prescriptions for Ms. Bertrand shortly after Mr. King’s death.
She was found dead days after that, on Dec. 2, a deadly mix of sedatives in her system.
The ensuing inquest has been a long time coming, admits Brockville Police Detective Constable Tom Fournier, who’s been following the case for nearly 30 months.
But “when you pick up a 19-year-old and you pick up a young lady essentially in the same room, within 11 days of each other, we kind of pushed and said it’s in the best interest of the public to have an inquest.”