Final Report

The final report on my brother’s autopsy is in.

I had been expecting the phone call for a while and I wasn’t entirely sure when I would get it. Last week it came. 327 days after my brother passed away his final autopsy report was ready and the medical examiner was calling me with the results. Even though I knew I would be getting this call at some point it still threw me for a bit of a loop when I got it. Memories came back and from out of nowhere a flood of emotions was washing over me. I quickly gained my composure and steeled myself for what I was about to hear, even though I already knew what the results would be.

There were no surprises. Ryan died as a result of multi drug toxicity, the manner of death accidental. Among the drugs in his system when he died were alcohol, methamphetamine, heroin, oxycodone, morphine, and codeine, but the one that killed him was fentanyl. He had five times the therapeutic level of fentanyl in his blood when he died. If nothing else I can take solace in the fact that my brother didn’t suffer at the end, he drifted off to sleep and died peacefully.

Ryan had been an addict for years before he died and he never denied it. He used to say “drugs do me” every once in a while and he wasn’t shy about his drug use either and had told me on many occasions that he figured he had done pretty much all the drugs. The exception to this at the time however being heroin and fentanyl. He told me once that he found no appeal in a drug that makes you puke your guts out the first time you use it. That and the fact that he didn’t like needles kept him away from heroin. That and the addictive potential that it had. He may have been an addict but being a heroin addict is on a much different and far scarier plane. It was the same with fentanyl for him.

Things had changed in the last year of his life though and he found himself spiraling down into a deep and dark place. He found himself living in a camper behind a house with the lowlife who would be his conduit to the poison that killed him. He knew the risks, but it was a very cold winter and he would do anything to feel warm. Relieving his physical and mental pain was simply an added bonus. It wasn’t long at all before he required it on a regular, daily basis otherwise he would be wracked with the physical agony of withdrawal.

I’m quite sure that at some point in his life somebody told Ryan that if he continued on the path that he was on that he would wind up being a statistic. In fact it’s something that every addict has heard at least once in their lives. I’m not sure how Ryan felt about that but the fact of the matter is that he is now a statistic, a number on an ever alarming tally sheet.

According to the Alberta Opioid Response Surveillance Report released by the provincial goverment and the Office of the Medical Examiner, Ryan was one of 49 individuals to accidentally overdose on fentanyl in Calgary in the third quarter of 2019. There were a total of 211 in Calgary for the year. In the first quarter of 2020 there were another 49. In fact from Q1 2016 to Q1 2020 a total of 983 people died from accidentally overdosing on fentanyl, the most of any zone in the province and ahead of Edmonton where there were 700 such deaths reported.

https://open.alberta.ca/dataset/f4b74c38-88cb-41ed-aa6f-32db93c7c391/resource/45e03e51-0fa8-49f8-97aa-06b527f7f42c/download/health-alberta-opioid-response-surveillance-report-2020-q1.pdf

What is alarming is the increase in the number of accidental overdoses of fentanyl from 2016 until the present. Of all accidental opioid overdose deaths in Alberta a staggering 89% are attributed to fentanyl. That is up considerably from 2016 when it began the year at 56%. I’ve sent an email to the Office of the Chief Medical Examiner to see if anyone would be able to provide me with an explaination for the big increase in Q4 over Q3 of that year. It is from this point that the number has been steadily increasing until the present day. I will provide updates as further information becomes available.

Welcome to the opioid crisis, which began in the 1990’s when Purdue Pharmaceuticals unleashed OxyContin onto an unwitting public. Falsely claimed to be non-addictive, the powerful narcotic was prescribed by doctors in large numbers. The results have proven to be tragic and incalculable. It has spawned an explosion in the number of prescription drug addictions and redically changed the demographics of addiction within a generation. Previously addicts became addicted after using ilicit drugs whereas now a large number of opioid addicts became addicted after using prescription narcotics like OxyContin. Todays drug addicts are housewives, business owners, school teachers and your next door neighbour, with no shortage of pro sports figures falling in these ranks as well.

Now fentanyl is prevalent, creating addicts in ever increasing numbers and killing indiscriminantly. Drug dealers stand to make huge profits from it and don’t seem to care that their business model is one that is killing off their customers. For them there will always be another addict to bleed, and another one after that. More and more, people are chasing the fentanyl dragon creating more and more work for medical examiners.

What’s heartbreaking to me is that Ryan had been talking to one of his closest friends about trying to find a rehab facility, and they were supposed to get together the following day. Ryan passed away later that night. If the heroin he got hadn’t been so laced with fentanyl he might have been able to find the help he so desperately needed, but it robbed him of that opportunity and us of Ryan.

My brother was by no means perfect but that didn’t make him a bad person. He would have his moods and could to get angry from time to time he was in his heart a good and gentle man. Softspoken, he had a kind soul and was the best and most loyal friend a person could hope to have, there for you should you need him. This still came through despite the battle he was waging against his inner demons. This is who I will remember and how he should be remembered, rather than for his faults or the way he left us.

For those of us that loved him it was hard to see him in so much mental and emotional pain and anguish, so yes there is the solace that comes with knowing that your loved one is no longer suffering. I however am looking at it slightly differently, in that it’s a good thing that he isn’t around to have to experience what the rest of us have had to since the beginning of this year. I know that he would have absolutely HATED being in lockdown and I really don’t know how he would have handled it, and given the current state of things and the direction they appear to be going in, it might be fair to say that he’s a lot better off than we are.

I will forever carry the burden that is carried by many who have lost a younger sibling. There is a feeling of guilt that goes along with it, survivors guilt perhaps, telling you that this isn’t how it’s supposed to work. The oldest is supposed to go first. Add to the that the feeling that you have broken what almost seems like a law of nature in that the older sibling is supposed to look out for the younger one(s). It would almost seem like a cop out to simply say I that I am not my brother’s keeper, but that’s the reality that I am coming to grips with.

I realize that his death, while significant to those that loved him, won’t have an impact on the opioid crisis we now find ourselves in. I hope and pray however that it might make enough of a difference to save someone’s life down the road, that way he will not have died in vain. I know this is what my brother would have wanted, and it’s what I will work towards while I am still here on this Earth.

I miss you so much little brother, we all do, and I look forward to the day when we see each other again. I love you buddy.

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