Long-term opioid users suffer with crumbling bones, brain injuries and little hope of treatment

Hugh Lampkin says he abused drugs — everything from pot to PCP — for decades. He started at about age 12 in Toronto.

Now in his late 50s, he's an overdose survivor who has beaten back his demons. But his past has taken a toll on his body, leaving his back bent at an impossible angle, and surgery out of reach.

Lampkin has lost count of the friends he's lost to overdoses and organ failure.

The opioid crisis has claimed more than 13,000 lives in his province since 2016. On Nov. 1, the B.C. Coroners Service confirmed another 175 suspected deaths in September. That's 10 per cent less than died in Sept. 2022, but still 5.8 drug deaths per day, with most deaths reported in Vancouver, Surrey and Greater Victoria.

Of the 225,000 British Columbians using unregulated substances, fewer than 5,000 receive safe supply prescriptions, according to provincial data.

Opioid overdoses have claimed 38,514 lives in Canada in the past seven years, according to the Public Health Agency of Canada. Many others survive, like Lampkin, but are left with injuries or chronic health issues that then hinder their rehabilitation.

Medical experts say those problems need more study and those people need more support. Today the B.C. Coroners death review panel urged the government to expand safer supply access to save lives and prevent injuries.

According to data from the Canadian Institute of Health Information, some 5,807 overdoses were recorded at Canadian hospitals (not including Quebec) between April 2022 and March 2023.

Of those, 327 suffered anoxic brain injury, meaning their brain was damaged due to a lack of oxygen. Anoxic brain injury is just one of the ailments that can affect overdose survivors. Statistics on the others are scarce.

It's not clear if Lampkin has a brain injury. He says his memory isn't what it was, and his once-long stride is now an agonizing shuffle along an East Hastings Street sidewalk in Vancouver's Downtown Eastside.

About a year and a half ago, a fall bent his spine almost 90 degrees.

"We were stacking some boxes one day and I fell off — and when I went to stand back up I couldn't stand up straight and it's been there ever since," he said.

Scan the sidewalks that border the Downtown Eastside and it's common to see residents with contorted spines, walkers and wheelchairs. Brian Conway, director of Vancouver's Infectious Disease Centre, says there are 500 or more hospitalizations per day across Canada as a result of overdoses and many more involving infections that can be introduced where an injection pierces the skin that can then spread to the blood, heart, brain or bones.

"The health-care system, currently designed, is failing the inner city," said Conway.

"There are more people that need more help in a different way."

These include a need for more monitoring and research of drug harms, especially as people age.

"There are many consequences well beyond, unfortunately, dying," Conway said.

"If infection spreads to the bones, causing osteomyelitis" — a serious bacterial infection — "this will cause the bones to collapse so that people will have collapsed spines; not be able to stand up straight, not be able to walk properly."

Organ damage, paralysis

Conway says opioid abuse can also lead to chronic health issues and damage to the heart, liver or pancreas.

Infections can spread through the bloodstream and cause abscesses and damage that can lead to mobility issues or even stroke or paralysis. In severe cases the mechanisms and glandular systems that help grow bone become damaged, and bones become decalcified, crack or even collapse.

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Conway works at the Vancouver Urban Health Centre on Main Street, where he offers medical care for people often failed by traditional hospitals.

Research around the effects of opioid damage and how that impacts rehabilitation is also lacking, according to Nora Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health in Bethesda, Ma.

Volkow says too little is understood about effects of multiple anoxic brain injuries — or how they could affect memory in old age.

"Does overdosing, particularly with multiple overdoses, increase your risk for dementia? And I predict it will," Volkow said.

And Volkow says new dangers are spiking right now in the U.S. where a non-addictive drug called Xylazine (often referred to as "Tranq") — which affects the vascular system and blood vessels — is often found combined with opioids like fentanyl. Volkow says these so-called Tranq cocktails often cause aggressive lesions that, if not treated properly, end in amputations.

'Tranq' ups risk of amputations

"This is a rising problem that we're actually right now seeing in the United States. We are seeing it accelerate because of the presence of a new drug that is being used to lace fentanyl," said Volkow.

The mechanisms of why Xylazine causes such aggressive lesions, are not yet clear, Volkow told CBC News.

Xylazine is showing up in small amounts in Vancouver, according to the dashboard that logs drug testing for the BC Centre on Substance Abuse.

Volkow says the weakening of the skeletal system and osteoporosis are more common problems; made worse because spinal surgery, like organ transplants, are rarely offered to long-time drug users.

"Those are extraordinarily complex surgeries in the best of circumstances… the spinal cord is not an easy place to do surgery," Volkow said.

'I've learned to live'

For Lampkin, the three-block walk from his apartment to his job at the Vancouver Area Network of Drug Users is excruciating.

"I try to use the walker because it's kind of painful and it tires me out quite a bit," he said.

By the time a specialist told Lampkin that he would not be considered for spinal surgery, due to past drug use, he'd been shuffling around — bent almost in half — for more than a year and a half.

Long before his fall, a previous infection in his neck vertebrae had spread into his spine.For now he's doing physio and trying to fix himself, by walking as much as he can. He says he used drugs as a kid for "comfort" to escape memories of abuse he suffered after a stranger abducted him as a child, derailing dreams he had of becoming an engineer.

"It was always popping in my head," Lampkin says. "My life wasn't the life that I picked," he said. "Some days I don't feel so good. But that's life, right? I've learned to live."