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B.C. mom whose two sons overdosed urges doctors to check prescription history

Both sons overdosed after being prescribed opioids
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Helen Jennens poses for a photograph in Vancouver, B.C., on Monday January 8, 2018. Jennens says the overdose deaths of her sons, Rian Leinweber in August 2011 and Tyler Leinweber in January 2016, could have been prevented if doctors had checked their drug histories on B.C.香蕉视频直播檚 real-time database PharmaNet. (Darryl Dyck/The Canadian Press)

Helen Jennens flips through two sets of documents 香蕉视频直播 one for each son who fatally overdosed.

Letters she sent in both cases to the College of Physicians and Surgeons of British Columbia alleging the careless prescribing of potentially dangerous medications are neatly organized among responses from doctors.

Jennens says the deaths of her sons, Rian Leinweber in August 2011 and Tyler Leinweber in January 2016, could have been prevented if doctors had checked their drug histories on B.C.香蕉视频直播檚 unique real-time database PharmaNet.

The provincewide network links pharmacies and hospitals to a central database that stores information on all dispensed prescriptions. The system is also available to physicians, but doctors say most do not use it.

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Jennens, who lives in Kelowna, has asked the college to make use of PharmaNet mandatory for all doctors so the files of high-risk or drug-seeking patients are flagged.

香蕉视频直播淏oth boys, I have no idea how they lived as long as they did, with the medications they were prescribed, the combinations they were prescribed,香蕉视频直播 Jennens says through tears.

Rian was 37 when he died, three years after a truck collided with his motorcycle, crushing his right leg from hip to toe, requiring multiple surgeries.

Jennens went to Rian香蕉视频直播檚 home with a pot of chili and found him propped up on his bed with his computer on his lap. He香蕉视频直播檇 stopped breathing from a combined overdose after being prescribed benzodiazepines, various drugs for insomnia and depression, and opioids for chronic pain while he awaited a second hip replacement.

Jennens says she香蕉视频直播檇 warned doctors Rian could become hooked on opioids because he香蕉视频直播檇 endured a decade of addiction that included cocaine and crystal meth.

香蕉视频直播淗e was eight years drug free when he got into that accident. I said, 香蕉视频直播榃e know legitimately he needs stuff for pain because his leg was shattered but we also have to stay on top of it.香蕉视频直播 香蕉视频直播

After Rian died, Jennens requested his PharmaNet records and questioned why he was prescribed such a wide range of medications including opioids.

香蕉视频直播淲hy didn香蕉视频直播檛 these people say enough? That was my whole issue with PharmaNet,香蕉视频直播 Jennens says. 香蕉视频直播滻t lets you know somebody香蕉视频直播檚 got a drug history. He香蕉视频直播檚 on this cocktail for three years and nobody is concerned about what may happen in terms of overdose?香蕉视频直播

A big part of Jennens香蕉视频直播檚 complaint with the College of Physicians and Surgeons focuses on mandating the use of PharmaNet, which she says could be optimized to protect patients.

香蕉视频直播淭hat didn香蕉视频直播檛 happen, and five years later, my second son died,香蕉视频直播 she says of Tyler, who had ruptured his left Achilles tendon in 2008 while playing football and was prescribed OxyContin.

He became addicted to heroin and unknowingly took what turned out be fentanyl in his ex-wife香蕉视频直播檚 bathroom, where he was found dead on the floor. A coroner香蕉视频直播檚 report says he had overdosed on the powerful opioid.

香蕉视频直播淗e used to lay in my lap at night and say, 香蕉视频直播楻emember when I played football? Why can香蕉视频直播檛 I get that back?香蕉视频直播 香蕉视频直播 Jennens says. 香蕉视频直播淗is sister saw him twice in the last three years of his life because she wouldn香蕉视频直播檛 subject her daughter to his behaviour, and it killed him. It香蕉视频直播檚 killing her now.香蕉视频直播

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Armed with 173 pages of PharmaNet records listing Tyler香蕉视频直播檚 medications, Jennens filed a second complaint and 香蕉视频直播減leaded香蕉视频直播 with the college to make the use of PharmaNet compulsory for all doctors.

Jennens香蕉视频直播 first complaint to the college resulted in one doctor being directed to take two continuing medical education courses on the responsible prescribing of opioids and strategies to manage chronic pain through less reliance on drugs.

Her complaint after Tyler died was forwarded by the college to 20 doctors who were cited for their prescribing habits. In their response letters, some doctors say they did not access PharmaNet, while others say Tyler香蕉视频直播檚 death prompted them to use it.

Dr. David Hawkins says in his letter that the medical system allowed Tyler香蕉视频直播檚 family to suffer 香蕉视频直播渁s a result of his death, and that was quite possibly avoidable. Certainly his medical encounters did not present him with treatment that could have offered him a way out of his situation.香蕉视频直播

Hawkins also offered an apology: 香蕉视频直播淚 am sorry for the part I played in Tyler香蕉视频直播檚 death and for not addressing his anxiety in an alternative manner at that time. I hope that the changes by both myself and the rest of the medical profession can help to tame this terrible crisis.香蕉视频直播

In an interview, Hawkins says using PharmaNet while treating addicted patients with chronic pain is time consuming, especially because it香蕉视频直播檚 not linked with electronic medical records so doctors must use different systems to get information about any tests and consultations.

香蕉视频直播淭o try to compare any one visit with another in the past is really challenging, and that香蕉视频直播檚 before you even see the patient so you香蕉视频直播檙e exhausted by the time you even enter the room,香蕉视频直播 says Hawkins, who works in Lake Country, B.C.

香蕉视频直播淚t could be done electronically, if someone were to program these systems properly,香蕉视频直播 he says. 香蕉视频直播漌e need certain things and we香蕉视频直播檙e just not getting them. I香蕉视频直播檓 not pretending that it would be easy but there doesn香蕉视频直播檛 seem to be any effort to make our jobs easier on the front lines.香蕉视频直播

Patients suffering from anxiety and depression also require more mental health support so drugs are not the 香蕉视频直播渆asy香蕉视频直播 answer, he says.

香蕉视频直播淚t香蕉视频直播檚 really sad, with so many young people dying, older people too. Fathers, mothers. It香蕉视频直播檚 horrendous what香蕉视频直播檚 going on,香蕉视频直播 he says of the opioid epidemic that claimed 1,422 lives in British Columbia alone last year, mostly due to street drugs, not prescription medications.

In the end, the college required one of the doctors, not Hawkins, to take a continuing medical education course in Tyler香蕉视频直播檚 case.

香蕉视频直播淚t is the college香蕉视频直播檚 expectation that each of these physicians will use this difficult case as an opportunity for further learning and professional growth for the benefit of future patients and their families,香蕉视频直播 Dr. K. Shaw of the complaints and practice investigations香蕉视频直播 inquiry committee wrote to Jennens in a letter dated Jan. 16.

The college told Jennens in a letter a year earlier that if it decided a doctor had 香蕉视频直播渕ade an isolated error in judgment,香蕉视频直播 it would take remedial, not disciplinary, action.

香蕉视频直播淚香蕉视频直播檓 not out on a witch hunt for doctors,香蕉视频直播 Jennens says, adding her years of lobbying is aimed at the college and the government to prevent the overprescribing of potentially addictive drugs.

香蕉视频直播淒octors now thank me for bringing this to their attention,香蕉视频直播 she says. 香蕉视频直播淭hey agree we need to do more about PharmaNet. Why didn香蕉视频直播檛 they just think about this before Tyler died? Why didn香蕉视频直播檛 someone search his PharmaNet records? Fifty pages of methadone and suboxone prescribed. They had to know it was drug-seeking behaviour.香蕉视频直播

In June 2016, as part of revised standards for prescribing drugs that could be misused, the college made the use of PharmaNet mandatory at walk-in and methadone clinics.

Dr. Heidi Oetter, the college香蕉视频直播檚 registrar and CEO, says the prescription monitoring system was 香蕉视频直播渂est in class香蕉视频直播 compared with any other in Canada.

However, she called PharmaNet 香蕉视频直播渃lunky香蕉视频直播 and says its ultimate success will require government officials to consult doctors 香蕉视频直播渢o really make it operational in their offices.香蕉视频直播

香蕉视频直播淲e香蕉视频直播檙e committed to making access to PharmaNet mandatory once everybody can easily access the system,香蕉视频直播 Oetter says.

Neither Health Minister Adrian Dix nor Mental Health and Addictions Minister Judy Darcy were available for interviews.

Dr. Trina Larsen Soles, president of Doctors of BC, the association that represents physicians, says PharmaNet should be enhanced to connect with medication records from hospitals, the BC Cancer Agency, the renal program and the HIV-AIDS program.

香蕉视频直播淚香蕉视频直播檝e got a cancer patient who香蕉视频直播檚 on various chemotherapy cocktails and pain meds and I don香蕉视频直播檛 know what chemo they香蕉视频直播檙e on because it香蕉视频直播檚 not on PharmaNet. I have to go to a different window to get that information,香蕉视频直播 she says. 香蕉视频直播淵ou香蕉视频直播檙e doing all this on the screen instead of talking to the patient in front of you.香蕉视频直播

Dr. Tom Perry, an internal medicine and clinical pharmacology specialist at the University of British Columbia Hospital, was a New Democrat member of the legislature when PharmaNet was launched in 1995.

香蕉视频直播淲hat an incredible resource,香蕉视频直播 he says. 香蕉视频直播滶veryone should have done it in Canada long ago, and we all should be hooked up to it.香蕉视频直播

香蕉视频直播淚f my records aren香蕉视频直播檛 perfect, PharmaNet rescues me or anybody else because PharmaNet not only tells you what I prescribed but it tells you what香蕉视频直播檚 more important, which is did the person fill (the prescription)?香蕉视频直播

Dr. Corinne Hohl, an emergency room doctor at Vancouver General Hospital, says installation fees and monthly charges also deter doctors from registering for PharmaNet.

香蕉视频直播淭his is a big disincentive, I am told, is to pay, and physicians who are private entrepreneurs in private offices simply don香蕉视频直播檛 want to have to pay the additional fee,香蕉视频直播 she says.

香蕉视频直播淚t香蕉视频直播檚 very beneficial, especially in the context of the current opioid crisis, where we香蕉视频直播檙e trying to be very careful about prescribing opioids. We want to make sure that the patient is receiving opioids consistently from the same provider as opposed to eight different providers from eight different hospitals if they香蕉视频直播檙e doctor shopping.香蕉视频直播

Camille Bains, The Canadian Press





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