Pubdate: Mon, 12 Mar 2018 Source: Globe and Mail (Canada) Copyright: 2018 The Globe and Mail Company Contact: http://www.theglobeandmail.com/ Details: http://www.mapinc.org/media/168 Author: Patrick White Page: A5 DEMANDING ANSWERS FOR THE 'UNDETERMINED' Curtis McGowan wrestled with his opioid addiction for years, but his suspected overdose while in prison raises serious questions On one of his many trips home from jail, Curtis McGowan beamed with pride and clutched a Dr. Seuss book. "Mom," said the six-foot, 300-pound foundry worker, handing Michele McPherson a copy of Green Eggs and Ham, "this is the first book I ever read." To mother and son, it was a moment filled with significance. He'd struggled with illiteracy his whole life, just like he'd struggled with drug use and mental-health problems. If he could learn to read, perhaps sobriety and serenity were not far off. "He was so proud of being able to read that book," said Ms. McPherson, staring at a funeral bill on her kitchen table in Guelph, Ont. "I still have it somewhere." In the age of fentanyl, parenting a child with drug-addiction issues is soul-testing work. The prospect of death hovers. Family and friends had encouraged her to show tough love. Every time Ms. McPherson offered her boy a nurturing hand in the form of a pack of cigarettes or some cash or just a hug, she wasn't sure if she was showing love or pushing him toward an early grave. Although it might seem counterintuitive, jail time can offer a rare break from the 24-hour stress of dealing with a loved one who is severely hooked on drugs. "I always thought he was safer in prison," Ms. McPherson said, "It seemed he couldn't get the drugs there. He always came out looking good and being his old self. It was his second home, sadly." But last year, unbeknownst to Ms. McPherson or her 32-year-old son, the Ontario correctional system was racking up a record number of deaths. When police sent Mr. McGowan to Maplehurst Correctional Complex on Sept. 1, 2017, for a break-in, he re-entered a system that would record 27 deaths by year's end, the highest tally among fatality records obtained by The Globe and Mail dating back to 2000. The public is not allowed to know why so many inmates died in provincial care last year. The Ministry of Community Safety and Correctional Services doesn't release information about non-natural deaths in custody until a full coroner's inquest takes place - an unwieldy process that can take upward of two years to transpire. Until an inquest, the government records the cause of all prison deaths - except those deemed natural - as "undetermined." That label applies to 75.9 per cent of all jail deaths since Jan. 1, 2014, according to provincial figures provided to The Globe. Dorijan Najdovski, a spokesman for the corrections minister, pointed to the opioid crisis when he was asked to provide an explanation for the death count. That rationale accords with anecdotal information from correctional officers, inmates and medical staff who spoke with The Globe. And it certainly rings true for Mr. McGowan's family. Ms. McPherson was an unwed teen when she gave birth to Curtis at a Catholic maternity home. The staff told her to "let him go" and brought in a number of potential adoptees. "I wasn't swayed," she said. "You could say I've fought for him since the day he was born." Diagnosed with a learning disability, ADHD and bipolar disorder, Curtis would drop out of school in his early teens. In his twenties, a doctor prescribed Percocet and then OxyContin for a foot condition. His sister, Amber, saw that the painkillers were making him sick. "He seemed to be getting the flu every week," she said. "And he'd start dozing in the middle of conversations. I went to his doctor and got him cut off." It was too late. The hook of addiction had set in. He began stealing. The first criminal charge came in 2010. By 2017, he had racked up 86 charges, 33 for breaching probation orders, which include a promise to "keep the peace and be of good behaviour." The family began to fear him. He threatened violence. A restraining order was filed. Both he and the family begged for help from the police, the courts and the health system. Nothing worked. Once again, people told Ms. McPherson to "let him go," but her maternal love was unconditional. On Aug. 26 of last year, she gave him some money to watch the Floyd Mayweather-Conor McGregor fight with friends at Boston Pizza. At 1:15 a.m. the next morning, a bystander found Curtis unconscious on a Guelph sidewalk. His lips and nail beds were blue, according to an EMS report. Doctors at Guelph General Hospital diagnosed his condition as an overdose and administered naloxone. He awoke, ripped out his intravenous lines and jumped from his stretcher, fracturing his right foot. Police arrested him minutes later for breaching probation. He was released the next day. On Sept. 1, he broke into a stranger's house. Police added three more charges to his record - break and enter and two probation breaches - before taking him on the familiar drive down Highway 401 to Maplehurst. While his family would be relieved to know he was no longer on the streets, it was not a place he would get the help he needed. A recent survey of Ontario correctional physicians found that a majority avoided starting inmates on opioid replacement therapy using methadone or Suboxone due to worries about the drugs being traded among inmates, safety and other issues unique to the jail environment. "It's inadequate," said Lori Regenstreif, an addictions physician who co-authored the research and used to practice at Hamilton Wentworth Detention Centre, of addictions care in Ontario jails. "It's not really considered a priority." With the recently introduced Correctional Services Transformation Act, the government has vowed to improve the quality of inmate care. And it has worked to reduce the drug trade in provincial institutions. The death count suggests results have been mixed. "Contraband is an issue in jails across the country, and around the world," said the spokesman, Mr. Najdovski, in an e-mail. "Despite all of the preventative measures that are in place, some contraband may enter our facilities. Our efforts to interdict contraband are being greatly assisted by the installation of state-of-the-art body scanners at our correctional facilities - Ontario is the first province in Canada to do so." On the evening of Oct. 6, two Guelph police officers climbed the stairs of Ms. McPherson's bungalow. Curtis was dead. Fentanyl overdose was the suspected cause - later confirmed in a toxicology report released to the family. The details of Mr. McGowan's final 35 days at Maplehurst are now the subject of a police investigation. Five months later, the family remains full of questions that likely won't be solved for years. The cause of death is classified as "undetermined." An inquest has yet to be scheduled. "How is it that he survived on the streets for years and then died in the care of the province?" Ms. McPherson said. "I've got my son in my bedroom in a velvet bag in a cardboard box that cost me $3,118. I'm not embarrassed of my son. I'm embarrassed for our society." - --- MAP posted-by: Matt