Brain injury a shadow crisis amid overdose deaths in British Columbia

VANCOUVER —

Edwin Bergsson’s friend broke down the door of his recording studio in Victoria about five years ago, found him unconscious, and saved his life.

“It’s incredible that I’m here today,” Bergsson said in an interview.

He had overdosed after taking what he believed was crystal meth. But while he counts himself lucky to have escaped with his life, Bergsson suffered a brain injury caused by lack of oxygen.

His Lyrics Studio folded after the overdose and he now works in a café operated by fellow brain injury survivors.

Bergsson still struggles with his short-term memory. In fact, he couldn’t remember exactly how long ago he overdosed.

“Maybe almost five years ago now,” he said. “I don’t have the details, but it’s, it was at night.”

It has taken rehabilitation and support for him to find his new normal.

Bergsson said he doubts most people in his situation would get the care, direction and community support he received after his extended hospital stay.

“I feel like there’s probably a lot of people who don’t get any of that and have this big gap of ‘how do I get through any of this,'” he said.

While the fatal overdose toll in British Columbia is staggering, experts warn that people like Bergsson are part of a far-reaching shadow crisis of brain injury and concurrent mental illness.

Dr. Daniel Vigo, B.C.’s chief scientific adviser for psychiatry, toxic drugs and concurrent disorders, says those with brain injury and mental illness fell into a blind spot for harm-reduction policies, such as safer supply and drug decriminalization, that instead became a form of “harm enhancement” for people with mental impairment.

He’s now trying to steer policy toward better serving thousands of brain-injured victims of the public health emergency that will mark its 10th anniversary next week.

“The problem was not that safe supply was wrong, not that decriminalization was wrong, not that voluntary care shouldn’t be the first option always — it is that the way that it was implemented was completely blind to the fact that for people with severe mental illness, harm reduction is not harm reduction, it is harm enhancement,” Vigo said.

“That safe supply is actually a disincentive for treatment and that involuntary care, when there’s a person with mental impairment, is a question of saving the person’s life.”

More than 18,000 people have died from toxic illicit drugs since the public health emergency was declared in the province on April 14, 2016.

But Dr. Michael Krausz, head of the addictions and concurrent disorders group at the Centre for Advancing Health Outcomes, estimates the number of overdose survivors is likely “between five and ten times higher” than the death toll.

“So, that means you have thousands of patients which need to be taken care of, and I don’t see any indication that is happening,” he said.

The BC Centre for Disease Control says people who have experienced a drug poisoning or overdose are 19.5 times more likely to suffer brain damage than those who had not.

“There is a growing population in British Columbia who have survived toxic drug poisoning and have been diagnosed with encephalopathy (brain damage) as the unregulated drug supply becomes more potent,” it said in a “knowledge update” last year.

“The rise in unregulated drugs adulterated with benzodiazepines and tranquillizers has amplified the risks of toxic drug poisoning for people who use drugs, making the issue even more complex.”

Krausz said any time people are unable to breathe for five minutes or longer “always causes brain damage.”

“That is a very basic fact. If you are overdosing and your brain is not supplied by oxygen for a certain amount of time, you have a high likelihood (of having) some brain damage done.”

Despite that — and the acknowledgment from the BCCDC — he said “the health-care system is not really prepared to take that seriously enough.”

AN ‘INVISIBLE’ CRISIS

University of Victoria professor of psychology Mauricio Garcia-Barrera said there are between 75 to 100 overdoses in B.C. every day, but it is difficult to estimate the number of people involved over time, since individuals can be involved in multiple incidents.

The brain injuries that result are often “invisible, and that’s why I think it’s overlooked,” he said.

Garcia-Barrera said people with brain injury can suffer cognitive impairments, including problems with attention, memory, motor function, emotional dysregulation and “executive deficits like difficulty making decisions, completing tasks or solving problems.”

B.C.’s Ministry of Health said in a statement “acquired brain injuries can be misunderstood and difficult to diagnose, which can make it challenging for survivors to access the care they need.”

Garcia-Barrera is part of a group of researchers working “to reach a consensus on the priorities and solutions needed to best serve people experiencing the intersections of brain injury, mental health, and addictions in British Columbia.” He emphasized the complexity of the phenomenon that he said touches many social systems.

“There is trauma, there is poverty, there’s a health system that is overtaxed, so there are so many layers into this, like an onion,” he said.

There is a well-established intersection between homelessness, addiction and brain injury, he said, pointing to a study published in The Lancet Public Health in January 2020 that found 53 per cent of unhoused people had a history of brain injury before they became homeless.

“That has to tell us something,” Garcia-Barrera said.

Shirley Wilson said the intersection of brain injuries and drug use is a “chicken or the egg” situation.

Bergsson acquired a brain injury as a result of his overdose. But for Wilson’s son Jacob, it played out the opposite way, after being run over by a pickup truck in 2018, when he was 21.

He had substances in his system at the time of the accident, but his mother said how he ended up on the road at 3 a.m. that day remains unclear.

Wilson said her son was resuscitated three times in the immediate aftermath — on the road where he was found, at Abbotsford Regional Hospital and in a helicopter as he was airlifted to Royal Columbian Hospital in New Westminster.

“They weren’t sure he was going to make it,” Wilson said.

After an extended hospital stay he was discharged and sent to a recovery house, where Wilson said his addiction took off.

“His drug of choice was meth, although he drank and still used cannabis,” Wilson said.

She said Jacob never received the support he needed, and after years of struggling and cycling through treatment options, he died of an overdose in an Abbotsford hotel on Nov. 11, 2021. His body was found on a wellness check, she said.

Wilson began speaking out in the years that followed about the systems she felt failed her son.

“His life is a testament to the failure of health care and social impact,” she said. “His life and what he went through has to matter.”

She is part of a group of people who encouraged the federal government to establish a national strategy on brain injuries.

The resulting Bill C-206, the National Strategy on Brain Injuries Act — which passed first reading in the House of Commons last June — calls for improved prevention, awareness, diagnosis, treatment and rehabilitation.

It also aims to address intersections of mental health, homelessness and unstable housing, interactions with the legal system and substance use.

As governments grapple with how to best respond to the toxic drug crisis, Kix Citton, executive director of the Nanaimo Brain Injury Society, said community services are seeing the need first-hand.

“Our organization is at capacity and slammed,” she said of the society that helps people “navigate life after brain injury.”

When people can’t get access to primary care, they go to the most accessible space, “which is community organizations,” she said.

“That pressure is showing up in our work. While the funding isn’t following suit, so we’re absorbing a lot of that demand.”

Citton said her organization is “purposefully low barrier” and does not require a diagnosis.

“When someone is managing, or trying to manage, their symptoms of a brain injury, it’s very, very difficult to do that without support, and the support’s just simply either are not there, especially in our rural communities, or are inadequate,” she said.

The need for services in Nanaimo has resulted in a three-week wait list at the society, she said.

Citton said the society that was founded almost 40 years ago began “talking about the intersection of brain injury, mental health and substance use” in 2018. She noted the connections with housing, mental health, income support among other issues.

“Brain injury is on both sides of that equation. It’s the cause of these things and it’s the consequence of these things, but it’s a hidden piece that we haven’t quite been able to wrap our heads around how to best offer these supports,” she said.

People need help to understand what is happening, how to self-manage and access the necessary supports, she said.

“We’re doing our best, but the funding and the resourcing has not kept up with the demand on services.”

Garcia-Barrera echoed that, saying the “most impactful” systems of care “tend to be free” but they also “tend to have limited capacity.”

He said another issue is that services related to brain injury, substance use and psychiatric mood disorders are often siloed.

“But what we identified in these conversations is a big barrier, is that there are no integrated services,” he said.

‘THERE WAS A BLIND SPOT’

Vigo said his 2024 appointment to advise the government on the toxic drug crisis was an attempt to “steer the ship in a different direction.”

He said the previous focus in B.C. was on harm reduction, including safe consumption sites, safe supply, voluntary treatment and the decriminalization pilot project, that was scrapped earlier this year. But, he said, such approaches do not work for the entire population, especially those with concurrent disorders.

He estimated there are at least 3,000 people in B.C. “who have severe mental illness, severe substance use and severe acquired brain injury.”

“So, these patients with concurrent disorders could not access addiction services,” he said. “There weren’t enough psychiatrists who knew how to treat them, and so there was a blind spot and these patients started developing acquired brain injury.”

He has made a series of recommendations that include a directive aiming to help clinicians and others decide when involuntary admission is appropriate.

The vast majority of people with mental disorders, including substance-use disorders, will not meet the “stringent threshold” for involuntary treatment, he said.

“Leaving treatment to the person at the moment that they seek it just doesn’t work for this group of patients, for the patients that have severe mental illness, and so there was a blind spot in that policy,” he said.

Other suggestions by Vigo the government is working to adopt include clarifying the use of the Mental Health Act for those with substance-use disorders, expansion of treatment and recovery beds, and creating mental health units in correctional facilities.

Krausz, meanwhile, is calling for proper training for emergency room physicians and for every patient to be assessed for cognitive function.

Garcia-Barrera said his hope is that everyone who suffers an overdose is screened for a brain injury, so those with a diagnosis can get the help they need.

Bergsson said his situation “stands out” from the norm because supports were provided proactively. After an extended hospital stay, he was connected to the Cridge Centre, a Christian-based organization that has been providing brain injury services since 1991.

He moved into a recovery house before eventually graduating to independent living.

But he’s not sure most people with brain injury would be ushered toward getting help, unless they had a story similar to his.

“I wouldn’t have taken any of these steps had I not been in the hospital and inched along.”

Bergsson now works two days a week at Second Chance Cafe in Saanich, which is run by the centre. He is praised by Cridge Centre staff as a warm and friendly presence, who occasionally breaks out in song.

“It’s amazing how much I remember from the songs of my past,” he said. “I have a constant Rolodex of mid-’90s music that just the playlist repeats in my head, so those songs just come up sometimes.”

Though he no longer works in the music industry, he continues to be a casual fan, spending free time with his eight-year-old daughter or playing video games.

Jacob Wilson’s story offers a tragic counterpoint.

“My hope is that we don’t have to recognize Jacob as a perfect person. We have to recognize that the people who were supposed to help him didn’t,” Shirley Wilson said.

“The system isn’t broken, it was never built, and people are inadequate with their own resources about how to do this.”

This report by The Canadian Press was first published April 9, 2026.

Brieanna Charlebois, The Canadian Press