BUREAUCRACY DROVE ACTRESS TO OVERDOSE DEATH, FAMILY SAYS

A Victoria actress who struggled for years with a heroin addiction died of
an apparent overdose last month in a desperate attempt to meet the criteria
for B.C.'s methadone program, say devastated friends and family.

And as startling as that seems, it wouldn't be the first time, says a local
physician approved to prescribe methadone.

Sheryl Fjellgaard, daughter of country musician Gary Fjellgaard, went to
the Victoria Methadone Clinic in the days before her death Oct. 24 to try
to get back on methadone, a drug that quells cravings for heroin, opium and
morphine.

But the clinic's physicians want people to produce two or three "hot" urine
tests over the course of a week before accepting them on the program.
Because Fjellgaard had been trying not to use heroin, her urine didn't show
the necessary traces of opioids.

"I saw her in our pharmacy the day she died, and she didn't know what to
do," says Krisaundra Chan, of Sukhi Lalli Pharmacy. "She wanted help so
badly. She'd been phoning every day for two weeks trying to get into rehab.
This was a woman who wanted to change, and now she couldn't even get on
methadone."

Methadone clinic executive director Brian Oswald denies that Fjellgaard was
turned away because of her urine test, but confirms that she wasn't
immediately approved for the program. Prescribing methadone to someone
without a history of opiate use can be fatal, he notes.

"She'd never been to our clinic before," says Oswald. "My staff obtained a
release from her to talk to her doctor so we could get her on quicker, but
she never came back."

Chan says establishing addiction in this case would have been as easy as
rolling up Fjellgaard's sleeves and seeing the array of track marks. A
check with B.C.'s central methadone registry would also have confirmed that
the 44-year-old songwriter and actress -- a regular for many years in
Kaleidoscope Theatre productions -- had been on methadone in the past.

"I've confirmed with two other methadone-clinic clients since then who also
told me they had to produce the hot tests before they could get on the
program," says Chan. "It's like telling an alcoholic: 'Get a case of beer
and drive through town, and if you don't kill anyone, we'll help you.' "

B.C.'s methadone program is run by the College of Physicians and Surgeons.
Nothing in the policy manual specifically requires evidence of dirty urine.

However, a minimum of one urine test is "advised" before people are
approved for the program. And Dr. Neil Crofton, one of a dozen or so local
doctors approved to prescribe methadone, says urine tests are the "gold
standard" and relied upon almost exclusively before people are put on
methadone.

"Someone obviously has to be an opiate addict to get onto the program. We
don't want to put anyone on methadone who doesn't need it, because it's
very addictive in itself," says Crofton.

"You don't need to do big amounts of heroin for it to show up in your
urine, but we do want to see that it's there. The college is pretty strict
about that. Requiring a positive urine sample is standard procedure."

Victoria physician Dr. Barry Gelling is aware of previous overdoses among
people trying to boost their chances of approval.

"I've seen this happen before, where people have tried to produce a hot
test and have taken too much, especially if they've been off heroin for a
period of time at that point," says Gelling.

The toxicology tests on Fjellgaard aren't in yet, but the circumstantial
case for overdose is strong: Her best friend Kym Hill awoke from a nap to
find her friend slumped over a desk in the back of Hill's Courtney Street
jewelry store, a discarded needle nearby.

Coroner Maureen Wint says it's too soon to speculate, but she's certain
that Fjellgaard didn't intend to die that night.

Hill had already taken Fjellgaard to the hospital emergency ward that week
in an unsuccessful attempt to get help for her "dope sickness," and to the
treatment centre on Pembroke Street two days before. A bed would be
available Saturday, Fjellgaard was told; she died on the Friday.

Pharmacist Sukhi Lalli, who has "argued repeatedly" with the methadone
clinic over the hot-test issue and other matters, says the importance
placed on urine tests forces people to continue using heroin while they
wait to be approved for methadone, a process that takes about two weeks.

"That's not a requirement of the College of Physicians and Surgeons, so
it's either the individual doctors or the methadone clinic that says this
is the way it is," says Lalli.

"To me, there's just no reason to do it this way."

Fjellgaard's father Gary was on tour in the U.S. when she died. He didn't
hear about her trying to boost her heroin levels to qualify for methadone
until her memorial on Oct. 29, which would have been Sheryl's 45th birthday.

The family had been helping with her addiction for a number of years, says
Fjellgaard, who lives on Gabriola Island.

She'd "been to the brink" several times in the past and always knew her
family was there for her, he says, but this time was trying to clean up on
her own.

"To be told that to qualify for methadone, she needed drugs in her system
- -- that just blew us away," says Fjellgaard.

"When any of these people step forward to ask for help, they need it now.
It's really very tragic, what happened to Sheryl. I think she would have
made it this time."