Monday, March 16, 2020

Light up the Darkness

Opioid use and abuse is on the rise, hiding in the shadows of many workplaces and relationships. But until those struggling, and those close to them, admit there is a problem, people will continue to die

Guide Magazine

Allan was in grade eight when he first tried weed. He did it to be cool. To fit in.

Around the same time, he started drinking. By the end of grade eight, he had developed a serious habit.

In grade nine, he met a new group of friends who introduced him to cocaine. Every time he partied, he’d consume a cocktail of weed, booze, and cocaine.

But then at age 19, he was introduced to heroin.

“Heroin was the ringer,” says Allan, a Local 6 member employed by a CLAC-signatory contractor. “It took over as my drug of choice, erasing cocaine and overtaking alcohol. After a week, I felt the effects of my first experience of opiate withdrawals. They were terrible, to say the least.

“It was scary. At first, I found myself using every day because I wanted to. However, that want soon turned into a need. I felt like I needed to use every day. The euphoric feelings I felt from the high numbed me from all emotions.”

Allan continued to use heroin. On the outside, it might have seemed that he had it together—wife, daughter, full-time construction job. But it was all a façade.

“While I was using, I failed to see how drugs were destroying my life, such as my relationships and the way that people—including my coworkers—saw me. I broke trust and promises. I burned through a lot of money and burned bridges with others.

“When I was on the job site, people would look at me differently, even though I was still good at what I did. Somehow, people knew that something was going on.

“But I couldn’t admit that I had a problem. Heroin takes away your ability to feel and to see yourself—to look in the mirror and tell yourself the truth.”

Allan finally hit rock bottom after a harrowing incident where he used heroin that had been laced with fentanyl—a drug 50 times more powerful than heroin. He almost died. When he woke up, he made the decision to seek help.

Allan is one of many thousands of Canadians struggling with opioid addiction. Most Canadians have heard of the opioid crisis. The sharp spike in opioid-related hospitalizations and deaths in the last five years has caught the attention of the media, and stories of tragedy appear regularly in the news.

Thousands of lives have been lost. Tens of thousands have suffered irreparable damage to relationships, careers, and physical and mental health.

While many people have a stereotypical view of opioid addiction—it only affects people with mental illnesses, the homeless, and other down-and-out individuals—the truth is that it’s all around us. Opioid addiction is in our communities, in our workplaces, and in our families.

Many individuals get hooked on opioids due to legal painkiller prescriptions for injuries. The problem is particularly prevalent in the construction industry, which sees 30 percent of all opioid deaths.

“These workers get hurt,” says Alex Kuiper, a CLAC representative working in Ontario who has also represented members in western Canada. “Your body gets banged up, but you’ve got to show up every day, so you need these pills to make you feel better.

“Soon, two pills turns into four and four turns into six, and then the doctor won’t prescribe them to you anymore. So you go see what you can get on the street.

“On a number of occasions, I’ve had a member who got injured at work or in a car accident slowly develop an addiction to what they were prescribed. And then eventually they turned to street drugs.”

It’s not just in construction. No industry is immune. With some of the highest rates of workplace injuries, high levels of stress, and, in some cases, ready access to drugs, the problem is creeping into healthcare as well. Drug diversion in homes and hospitals is not uncommon, but mechanisms to catch and prevent it are often not up to the job.

“Even with controls in place for medications, it doesn’t really work,” says Dennis Oenema, a CLAC representative in the healthcare and social service sectors in BC. “Someone can go to the closet, get the drugs, sign off, and pretend they’ve given them to the resident when they haven’t.”

The Opioid Crisis - An Infographic

View the sobering statistics on the opioid crisis in Canada.

No matter what the industry, two big barriers to helping struggling workers get the help they need are stigma—both internal and external—and a reluctance by everyone around them to speak up when they suspect there may be an issue.

“The fear of losing your job and the shame and social stigma of being an addict are huge obstacles to seeking help,” says Alex. “People don’t want to lose their status in society, and they often think they are hiding it or getting away with it—until it blows up in their face.”

While workers who are struggling are busy hiding and denying their problem, their coworkers can often see the signs, but are reluctant to say anything.

“A lot of times it goes undiagnosed, and there is a lot of awkwardness in the workplace,” says Alex. “People just dance around the issue. Sometimes, other workers make fun of or look down on the struggling individual because their behaviour is weird. But they don’t say anything to anyone else.”

Jon, a human resources professional with a CLAC-signatory construction company, agrees. “Sometimes, coworkers end up being enablers by not mentioning anything,” he says. “They have this mentality of not wanting to rat on people. They don’t want to get involved or get management or the union involved.”

“It’s hard for employers to have those conversations too,” says Alex. “They don’t want to offend their employees or accuse them, and sometimes they are afraid of the hassle of having to accommodate them.”

But in the dangerous world of construction, if someone is under the influence, they may harm not only themselves, but their coworkers or members of the public.

“It ends up affecting the safety of everyone on the job site,” says Jon.

Unfortunately, all too often it takes a dramatic event, or a series of smaller but still serious events, to alert management and the union that there is a problem. For Allan, that moment was his brush with death.

“I didn’t know Allan well,” says Alex. “But I heard through the grapevine that something happened, and drugs were involved. I’m his rep so I tried calling him multiple times, but I couldn’t get a hold of him. Finally, I called him after hours and he picked up. He was terrified—he thought he was in trouble with the law, and he broke down over the phone.”

At that point, Allan wanted to find help, but he was scared. Scared of losing his job, and scared of losing his home. He was coming off of a winter layoff and money was tight. He couldn’t afford not to be working, but he knew he needed to deal with his addiction.

“I told him that for his and his family’s sake, he needed to get help,” says Alex. “As his union rep, I would make sure he had a job to come back to and make sure that in the meantime, his family wouldn’t lose their home. I requested aid from the union’s hardship fund to cover their housing and drove to his home to hand the cheque to his wife.”

Allan’s employer was fully supportive of Allan, encouraged rehabilitation, and promised him he would have a job to come back to.

With the support of his wife, his employer, and his union, Allan entered a residency rehab program fully committed to breaking free of his addiction.

“In treatment, I engaged and participated in groups such as relapse prevention, mindfulness, life skills, and spirituality,” says Allan. “I trusted the counsellors and put my life in the hands of the professionals. I surrendered to the fact that my way of life was out of control, and I needed help from others.”

Not everyone’s journey to healing begins as dramatically as Allan’s.

“If we suspect someone is struggling, we sit down with them and talk to them privately,” says Jon. “We try to establish a good line of communication with them and explain our employee and family assistance program [EFAP] and see if they’ll discuss the issue. Some are pretty open and some aren’t.

“We spell out why we have concerns—absenteeism, performance, and other work issues. If they are willing to accept help, we’ll come up with a plan to assist them—whether it’s through our EFAP or through the public healthcare options or a residency-type program.”

Employers are legally obligated to keep a person’s job open for them while they are off dealing with their addiction.

“Once workers find this out, they have more resolve to move forward with treatment,” says Alex. “They know they’re not going to lose everything.”

An important part of recovery is reintegration back into the community—including the workplace community.

“We work with the individual, the counsellors, and whoever else is involved to come up with a safe return-to-work plan,” says Jon. “I want to set them up for success and not failure. I want to put them in a situation where they’re going to be comfortable and where they are able to do the tasks.

“Depending on the individual, I have to do it in stages, such as small jobs, training, retraining, education—things to ease the guys back into work and back into the routine. If they have a special skill, then I try to ease them back into those crews.

“There’s also a lot that goes into educating the other crew members too to make them aware of what’s going on and make sure everyone is comfortable with the situation. But we aren’t going to do that if the individual isn’t ready to talk about it.

“It is much easier if the individual is willing to talk about their addiction. Once they get the chance to talk about it, their coworkers are more accepting of it.”

Allan successfully returned to work a few months after entering rehab. He and his employer and CLAC all worked together to make the transition as seamless as possible. So far, it has been a success. By seeking help, he is turning his back on addiction and moving forward again with his life.

“I finally feel like I’m getting my life back,” says Allan. “I don’t need to mask my emotions with drugs; I don’t need to suppress my feelings.

“I’m okay with accepting 20 years of heroin and fentanyl abuse. I’m okay in my own boots.

“Ultimately, my goal is to stay clean for the rest of my life. All of the heartbreaks, tragedies, and hardships will fuel my sobriety.

“Am I embarrassed? Yes. Am I scared? Definitely. But I am alive. I am here.

“I am straightening out my life. No more hiding. It’s time to light up the darkness.”

How to Help

Enabling Recovery, Not Addiction

When someone we care about is struggling with addiction, we often want to shield them from the consequences and cover for them. But by helping addicts avoid their problem, we are making things worse in the long term for them and everyone around them.

“Stop pretending you are doing them a favour by protecting them from being caught,” advises CLAC Representative Alex Kuiper. “The truth is, you are enabling them to ruin their lives even more. Don’t be afraid to call them out on their behaviour. It’s an awkward conversation to have, but if you see the signs, take action.”

5 Things to Do When a Coworker Is Struggling

Get advice from your steward, supervisor, or union representative or talk to your EFAP provider, an addiction service provider, or other knowledgeable professional.
Know your workplace drug and alcohol and health and safety policies.
If you believe a coworker is impaired and presents a workplace health and safety risk, report your concerns to your supervisor or health and safety rep immediately.
Don’t cover for a coworker suffering with an addiction. Doing so allows the person to avoid the consequences of his or her actions and may prevent your coworker from getting the help he or she needs.
Talk to your coworker. Don’t accuse, and don’t try to tell him or her what to do, but let the person know you are worried and you are there for him or her. Remind your coworker of resources that are available.

5 Things to Do When a Loved One Is Struggling

Recognize the problem. Your loved one is likely in denial and you may be as well. This is a common defense mechanism, but it needs to be addressed before change can occur.
Don’t blame yourself. You are not responsible for the actions of others.
Find positive support. Talk to a counsellor, join a group, or read a book that can advise and encourage you.
Talk to your loved one. This won’t be easy, and it may lead to strain or elicit anger. But by avoiding the issue, you become an enabler.

Do your homework before your conversation so you have a greater understanding of the issue.

Communicate in a relaxed, friendly manner.

Avoid accusations, particularly if you don’t have proof. Instead, focus on the troubling behaviours that indicate there is a problem.

Listen actively. Use clarifying statements and use the word I to avoid sounding accusatory.

Talk about the effects that the behaviours are having (on you, the relationship, the family, work, the individual, and others) and how to deal with them.

Encourage the person to think about next steps and creating a plan to seek aid in recovery.

Be prepared for hostility and rejection.

For those who are inclined to judgment and writing off the other person, remember that they, like you, are human. We all struggle with something. A healthy dose of forgiveness and understanding is key.

Source: workhealthlife.com

The Changing Face of Overdose

Dennis Oenema, a CLAC representative in the healthcare and social service sectors in BC, has volunteered at Metro, a local drop-in centre in Kelowna, for many years. Most of the clients who visit are homeless or living in precarious situations. A number of them struggle with substance abuse.

“Over the past couple of years, we’ve lost about 35 people to overdoses who were connected to our centre,” says Dennis. “But it’s actually getting a little bit better because there is a big shift taking place in the street community. People are carrying naloxone kits, and we have them here too.”

Naloxone is a drug that blocks the effects of opioids and is used to save the lives of people who have overdosed on opioids. Opioids depress the central nervous system and the respiratory system, which can lead to death.

Naloxone knocks opioids off the brain’s opioid receptors for a short time (20-30 minutes), which allows the person experiencing the overdose to breathe again. It can be injected under the skin, into muscles or a vein, or sprayed into the nose.

“On the street now, everyone knows everyone,” says Dennis. “If they see something happening, they will respond right away.

“But the number of people dying of overdoses isn’t going down—it’s just shifting to a different demographic. Now, it’s the middle class and the upper class who are doing drugs at home on their own. If they overdose, no one is there to help them and they pass away.”

Are You Struggling with an Addiction?

If you’re struggling with substance use, many resources are available to you from CLAC, public health services, and possibly at your workplace.

Your CLAC steward and representative – They can get the ball rolling to get you into a recovery program, work with your employer to keep your job open, and help when the time comes for you to return to work.

CLAC Substance Abuse Case Management (SACM) program – The program’s dedicated case managers personally work with members in the following four ways:

Provide referrals to substance abuse experts who assess and diagnose substance use disorders
Provide access to resources for treatment and recovery
Help with applications for short term disability, substance abuse subsidy, and other available funding
Monitor aftercare recommendations once a member has returned to work

Members can be referred by their employer, CLAC representative, or steward or can self-refer into the program. Support is also available to people in the addicted person’s life. For any questions or referrals, please don’t hesitate to contact a CLAC substance abuse case manager at 877-863-5154 or SACM@clac.ca.

Employee and family assistance program (EFAP) – If you are covered under a CLAC Health & Welfare Trust Fund benefits plan, you can get immediate, free, and confidential help through the Morneau Shepell EFAP. Access is available 24/7 by phone (844-880- 9142), on it’s website (workhealthlife.com), or by mobile app. In some workplaces, members may be covered by a different EFAP program. Check your collective agreement or ask your steward or representative.

Human resources department – The staff in your company’s human resources department can help you access various workplace resources and can help create a plan for recovery and ultimately return to work.

Healthcare professionals – Your doctor will have access to and can refer you to the appropriate healthcare professional to help you with your addiction.

Support groups – A number of support groups are available across the country to help you, including Alcoholics Anonymous, Narcotics Anonymous, and others.

Reaping the Whirlwind

North America is addicted to painkillers—many of them opioids. The widespread prescription and use of opioids has led to a massive increase in addiction to both prescription and illicit drugs (80 percent of heroin users started with other opioids). So how did we get here?

Humans have used (and sometimes abused) opioids for millennia. But in the late 1990s, their use began to grow exponentially. Starting in the 1980s and through the early 1990s, various medical associations and even the World Health Organization recognized that the medical profession wasn’t managing patients’ pain well, and it was leading to a lot of needless suffering. Their findings primarily dealt with cancer and postoperative patients.

The pharmaceutical industry jumped on this and began producing and aggressively marketing opioids (such as oxycodone) as safe alternatives to existing medications for all types of pain. By 2016 in Canada, doctors were writing over 21 million prescriptions per year—enough for more than one in two Canadians.

Today, we see the effects in the massive rise in addiction and death. A number of American states and Canadian provinces have launched lawsuits against large drug manufactures such as Pfizer and Purdue Pharma to recoup the skyrocketing costs of healthcare.

Sources: Globe and Mail, ncbi.nlm.hih.gov