In most parts of the country, anyone can open a drug rehab clinic, even if they don't have medical credentials, and make hundreds of thousands of dollars off of it.
After Michelle Jansen's son Brandon told her he was addicted to fentanyl, she started phoning rehab clinics around their hometown of Coquitlam, BC.
She tried everything to help him quit: detox programs, counselling, government-funded rehab treatment centres, and private ones. As the owner of a successful insurance company, cost was no object.
Still, after two years and more than $200,000 in treatment fees, nothing was working. It was shortly after he checked into his 11th rehabilitation centre in March that Brandon died of a fentanyl overdose. It was two days before his 21st birthday.
"Even when you have the means to afford private care, like I do, these treatment centres are a travesty," Jansen said in an interview outside of her Port Coquitlam office. "A lot of them have drugs running freely through them, they promise you all kinds of therapy and sessions and counselling. But it's so unreliable. There's no accountability."
And this is the case across the country. With lengthy waitlists for treatment at publicly-funded facilities, a host of private entities—many not even run by doctors—have opened to fill the void. In most of Canada, there is no government oversight. Anyone with a business license can open a clinic and charge patients whatever they want.
The issue gained renewed attention this month after a chain of drug and rehab centres in Alberta and Ontario shut its doors amid allegations of fraud. A growing chorus of experts and families dealing with addiction are calling for oversight of Canada's flourishing private drug rehabilitation industry.
In the meantime, patients are left with the burden of figuring out who to trust.
"Right now, if you were working as a librarian or a mechanic, you could open up a place and be an alcohol and drug counsellor," Tom Gabriel, former head of the Canadian Addiction Counsellors Certification Federation, told TVO earlier this year. "There are people who just decide one day that they want to be a counsellor and they don't even have a Grade 12 education."
"The public is uneducated and they're at risk," he warned.
In 2011, Quebec made it mandatory for such facilities—both public and private—operating in the province to get accredited, although it's by an independent agency, not the government. In BC, public and private long-term residential care centres that provide care to three or more people must obtain a license.
In Ontario, however, the health ministry has repeatedly said it has no plans to pursue regulations for private clinics.
In total, about 65 percent of the country's estimated 400 public and private agencies that provide residential substance abuse treatment have any relationship with an accreditation body in Canada, according to the Canadian Centre on Substance Abuse.
Perhaps the most well-known accreditation organization here is Accreditation Canada, an independent non-profit group. The vast majority of provincial and territorial health ministries contacted by VICE News said they rely on the group to accredit the facilities it funds. Private facilities are also get accredited this way.
However, a spokesperson for Accreditation Canada told VICE News that the group does not "investigate or mediate complaints" about these facilities, and that a single complaint "would not lead us to revoke the accreditation status of an organization." Instead, the group says it ensures that accredited entities have their policies to deal with complaints internally.
Accreditation Canada would not disclose any complaints it has received—it's under no obligation to make those public. And it is not subject to regulations or government oversight.
Despite years of complaints, lawsuits, and criminal charges against private clinics across the country, there has been little success in compelling them to adhere to any official standards.
"My son couldn't get in front of the fentanyl because he didn't have the proper care," said Jansen, who is suing the facility where her son died, alleging they breached their duty of care.
For more than a year, the Canadian Centre on Substance Abuse has been working with certification and accrediting bodies to help promote better oversight of the drug rehabilitation industry, however it's unclear when or if that will result in an official regulatory framework for private facilities.
Calls for such a framework have increased again this month after Addiction Canada, a private chain of drug rehab centres announced it was closing down. The company has been accused of not paying its staff, and the CEO and other employees are in the throes of a multi-million dollar fraud case and have been also been charged with drug trafficking and impersonating doctors. The company had boasted its accreditation with an international accreditation group that doles out a "mark of excellence" badge to facilities that complete an online survey and pay a fee.
Last year, a group of families and drug users in BC demanded refunds from a private centre in Maple Ridge that marketed itself as an addiction treatment and counselling facility. The centre had also been subjected to multiple lawsuits over the past five years. According to the families, the facility did not provide proper medical supervision as promised, and that counselling sessions were routinely delayed or cancelled.
With files from Michael Robinson.
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