‘No one was getting any better’: When private addiction treatment centres put patients in danger

Emily Bogen doesn’t quite remember the moment her family suggested it was time to get her help.  

After past struggles with alcohol, she was battling prescription drug addiction and neurological symptoms from Lyme disease. The Los Angeles resident knew she needed a treatment centre with specialized care to help her situation.

“I started to experience unusual things … I did start to struggle with the procedural memory stuff. I would struggle to figure out how to get ready for work. I just have never not had control of things,” Bogen told the fifth estate.

Bogen’s mother, Shawn Bogen, searched online and came across a privately owned residential treatment centre operated by Nomina Wellness on Vancouver Island.

But what seemed like an answer to their problems turned into an ordeal. They say they were promised a tailored treatment plan, one-on-one care and five-star service, at a cost of more than $30,000 for three weeks of care. But it never materialized.

This Nomina treatment facility and another in Courtenay, B.C., were the sites of several troubling issues, including the overdose death of a 27-year old man in October 2024. 

The Bogens’ story highlights a problem across much of Canada: for-profit, privately owned residential substance use treatment facilities operate with little government regulation or oversight, which critics say puts the lives of patients at risk. 

An investigation by the fifth estate reveals that provincial governments appear to have limited interest in managing the privately owned recovery sector, where there are no regulations providing specific rules on how they should operate, types of staff or what treatment they offer.

In the summer of 2024, Shawn Bogen reached out to Lisa Klco, co-owner of Nomina Wellness, hoping they would be able to treat Emily’s substance use issues, as well as her Lyme disease. 

“I felt like I trusted her. She said all the right things. I felt relief. I felt like she was telling me the truth,” Shawn Bogen told the fifth estate.

The Bogen family had high hopes for the facility.

“It looked like a beautiful location … they made it seem like they would be going on hikes all the time,” Shawn Bogen said.

Emily Bogen said they were promised a staff that included a physician, naturopath nutritionist, psychiatrist, psychologist and counsellors.

But when they arrived on Vancouver Island, the Bogens found something much different: a small home in a middle-class neighbourhood in Courtenay and a far cry from what the website led them to believe was where Emily would be staying.

“The clients there called it a crack house,” Emily Bogen told the fifth estate.

During her eight weeks at Nomina, Bogen said she never received treatment for Lyme disease, was isolated from her family and was getting counselling from staff who hadn’t graduated from any training program. 

“No one was getting any better. It was just a joke, the classes were a joke, the activities were a joke,” Bogen said. 

In declining an interview with the fifth estate via email, Klco wrote that their website “accurately captures our services and supports including our facilities” and that “all clients voluntarily elect to enrol in our program.”

Looking for help for her daughter

The lack of substantive regulations governing private residential substance use treatment centres is an issue former B.C. chief coroner Lisa Lapointe has been trying to raise awareness about for years.

Since retiring in 2024, Lapointe has regularly advocated for better regulations and more oversight of the recovery industry. 

“I feel like whenever I speak about this, people are always shocked,” said Lapointe. 

“If I take my dog to a vet, I see the veterinary degree on the wall, I’m confident that the person has been trained to a standard that is acceptable in my province,” Lapointe told the fifth estate.

“When you take your vulnerable 19-year-old or 20-year old to a private residential treatment centre, there is no oversight body. There are no standards.”

Compounding the problem, critics say, is the lack of requirements for training and certification for addictions counsellors. While there are numerous courses and different certification organizations, there’s no provincial requirement that private facilities employ certified professionals.

“People can just offer themselves up as addiction counsellors without any certification whatsoever or anyone watching what they’re doing,” said Doug Brewer, executive director of the Canadian Addiction Counsellors Certification Federation.

“It’s pretty much the Wild West. Basically anyone can call themselves an addiction counsellor. ”

The lack of regulations also leads to questions about who is accountable when something goes wrong. 

In October 2024, a client at Nomina left the facility. When the 27-year-old man returned, he locked himself in a bathroom. According to clients at the facility who spoke to the fifth estate, others in the home soon realized he was overdosing. One client broke down the bathroom door, while a staff member went outside and came in through a window.

They both began administering CPR. The staff member called 911. Paramedics arrived but couldn’t save him. 

The fifth estate is not revealing his identity at the family’s request because of the stigma around addiction.

“Honestly I still really can’t believe that it’s happened,” said Emily Bogen, who had checked out of the facility before the death happened but heard about it from a patient who was there that day.

The fifth estate investigation uncovered inconsistencies in whether there was naloxone — the fast-acting medication, also known as narcan, that can quickly reverse an opiate overdose, if given properly and early enough— at the facility. 

According to the 911 incident report, the staff member who called responded “no” to the operator when asked if there was naloxone available.

Two sources, both clients at the Nomina facility, also told the fifth estate that there was no naloxone available before the paramedics arrived. 

But when contacted by the fifth estate, the staff member who called 911 gave a different version of events, saying there was naloxone and he administered it.

That’s reflected in the coroner’s report, which lists the death as non-suspicious and the result of an overdose of fentanyl “at a concentration associated with fatalities.” The report says naloxone was administered by both staff and paramedics.

The fifth estate contacted the coroner’s office about the discrepancy and they say they are reviewing the information the fifth estate provided.

According to B.C.’s Standards for Registered Assisted Living and Supportive Recovery Services, which private residential treatment centres fall under only if they are registered with the province.

Nomina does not appear on any B.C. government registries for private residential treatment centres, including the non-registered list. There is no requirement for facilities to register with the province.

Only Quebec and Alberta provide some regulation for privately owned treatment centres. B.C. partially regulates private facilities that opt to register with the province.

Ontario Health Minister Sylvia Jones said overall regulation and oversight of the private sector isn’t necessary because so many professions in those treatment facilities are governed by their own professional colleges.

“There are many regulations and oversights of our regulatory colleges, whether it is the College of Physicians and Surgeons, the College of Nurses, 26 regulatory colleges in the province of Ontario have the ability and do, upon occasion, review, do investigations and in some cases pull licences for medical practitioners who are not following the appropriate rules for their particular clinical expertise,” Jones said in response to  questions from the fifth estate at a news conference.

Ontario health minister responds to questions from the fifth estate

But the problem with that approach, critics say, is that most provinces don’t require private treatment facilities to employ those professionals. That leaves the door open to hiring staff with little or no training. 

Brewer said it leaves room for companies to take advantage and profit off the gaps in the system.

“That doesn’t take away from the thousands of qualified, certified people who are doing really good work. But there are people, in the space, who aren’t following any rules or have any credible training and are just out there doing harm in some cases.”

The dangerous practices former clients describe are not isolated to one facility. 

In Ontario, a high-end facility known as Muskoka Recovery, about 200 kilometres north of Toronto, was also the site of a death in the spring of 2024.

A mother of four died after being given only half of her daily seizure medication, according to a report published in the Toronto Star.

Clients who spoke to the fifth estate say they later learned that some of the staff, who were passing themselves off as nurses, were not licenced. They also discovered, through online registries, that the clinical director had lost his licence as a social worker after being found guilty of sexual misconduct at a previous job.

“I had a few panic attacks, had a few days in bed. I’ve just been taken advantage of in my most vulnerable moments,” Kim Smith, a former patient at Muskoka Recovery, told the fifth estate.

Checking into an employee’s background

Smith is one of three plaintiffs in a proposed $40-million class action lawsuit against Muskoka Recovery that claims it “systemically misled, lured, financially exploited, abused and endangered vulnerable people seeking treatment at the facility.” 

The court hasn’t yet ruled whether the case will be certified. 

In a response to the fifth estate, Muskoka Recovery’s lawyer wrote: “My clients categorically deny all of the allegations … and look forward to having the opportunity to defend themselves in court…. If the government of Ontario forms the view that greater regulation is appropriate, Muskoka Recovery does not oppose this step.” 

Smith said she was given the wrong dose of medication by a staff member claiming to be a nurse. But when Smith, herself a registered nurse, went on the Ontario registry to look up the staff member’s credentials, she couldn’t find them.

“My jaw hit the floor. I’m going: ‘Something’s not right. No, this can’t be happening. I’ve got to be wrong.’ It’s so hard for me to trust. Even the medical doctors, other nurses, it’s hard for you to trust before I went in there. Now it’s even more difficult.” 

Lisa Lapointe, the former B.C. chief coroner, says one major flaw is that the system doesn’t track patient outcomes, so often the individual is blamed for not responding to treatment when the problem could be bigger.

“If we knew the extent of people who have been through treatment and subsequently died, I think we would soon figure out pretty quickly we can’t hold these individuals accountable. There is a whole system that is not meeting any particular standard, that this is a system that is a failure.”

Lisa Klco, Nomina’s co-owner, declined an interview request from the fifth estate. In an email, she said: “Nomina has and will continue to comply with all regulating inspections and standards pursuant to the relevant legislation to support our clients.”

The fifth estate did find a case where a former client took Nomina to court. A patient left after eight days and demanded he get back most of the more than $45,000 he had paid.

In the notice of claim filed in B.C. provincial small claims court, he said he was “not provided with a caring and safe environment.” 

He said that he “was given substandard accommodation, no meaningful treatment and was denied access to his inhaler, which was a medical necessity for him.”

In its court filing, Nomina responded by saying that “the care and treatment provided to the claimant was reasonable, skilful, careful and proper in every respect and within the accepted standard of practice in British Columbia and elsewhere in Canada, and was carried out in a competent and reasonable manner without negligence or lack of skill or care, at all material times.”

The case was settled out of court in December 2024.

Lapointe says provincial health ministries need to act. 

A possible reason for lack of government regulation

“It has to change. We cannot continue to have these people who are so vulnerable and in such a challenging health condition be really at the mercy of a private corporation that can charge what it wants and basically provide what it wants in the name of treatment.”

Emily Bogen is still trying to come to terms with her experience at Nomina. 

“I blame Lisa [Klco] … because I just know that she didn’t care about us,” Bogen said.

Her mother, Shawn Bogen, says she felt like she trusted Klco.

“I realize now that that really, so much of that was just, it was fraudulent.”