While the COVID-19 pandemic has dominated the news since March, provincial health officer Dr. Bonnie Henry noted in a recent briefing that it’s not the only health crisis the province is facing.
For the past four years, British Columbia has been grappling with an opioid overdose epidemic, officially recognized as a health crisis in 2016. As businesses have grappled with the pandemic, the construction industry has had to simultaneously struggle with the opioid crisis.
There is a greater than one-in-two chance that an employed person who suffers an overdose works in the trades. According to a 2018 report, the construction trades accounted for 55% of the overdose deaths among employed people, more than double the second-most-affected industry, sales and services, at 21%.
While the trades have suffered more than half of the overdoses in the province, they represent just 15% of B.C.’s workforce. This issue is not unique to British Columbia; other provinces and countries are reporting similar statistics.
“This isn’t a jurisdictional issue, this is actually construction issue,” said Vicky Waldron, executive director of B.C.’s Construction Industry Rehabilitation Plan (CIRP), a non-profit alcohol and drug treatment program co-sponsored by unions and management.
“We need to come together as an industry to start tackling some of these issues, we can’t continue to work in silos, we’re not helping any of our members by doing that.”
Waldron attributed the higher usage and overdose rate in the construction industry to the demographic of the workforce, the pain associated with manual labour and the culture within the industry to get back to work quickly after an injury, largely encouraged by the trades shortages. There is also a higher number of workplace injuries within the trades that could also lead to opioid abuse problems.
“When you have an injury, it’s actually a long, slow process to healing,” said Waldron. “Unless you … take an opioid.” Mental health issues are also heavily related to substance abuse, and Waldron said construction industry workers are more likely to struggle with suicide, post-traumatic stress disorder and childhood trauma than their counterparts in other sectors.
Waldron said the sector is heavily male dominated and men have more trouble discussing their issues and dealing with their mental health.
Three years into the provincial health crisis, 2019 began to show some promising results. Overdose deaths had dropped 36.6% to 81.6 per month compared with 128.8 in 2018. This year was on tract to follow a similar trajectory with fewer overdose deaths reported in January and February than in the same months in 2019.
Typically overdose deaths spike in March, and while the upsurge in March from February 2020 was greater than the respective increase in 2019, March 2020 still had fewer overdose deaths than the same month last year.
However, in April 2020, a month when overdose deaths usually fall, they continued to grow. Deaths escalated in May and reached a record monthly total: 170 overdose deaths or 5.5 a day, jumping 44% from the previous month and 93% from the same time last year.
Waldron said the two health crises are linked, and that COVID-19 and the public health precautions taken to fight the pandemic have in part led to the increase in overdose deaths.
“I know in the program, anecdotally, we were seeing a huge increase in the number of calls,” said Waldron in a webinar hosted by the BC Construction Safety Alliance. “We’ve had the highest number of clients we’ve ever had in the program in four years in March and April.”
CIRP had a 47% increase in calls in April, and Waldron said the program is hearing from construction companies that there are more workers are using opioids and suffering overdoses.
Waldron added that the stress caused by the pandemic is driving more people to misuse drugs, and the pandemic is interrupting effective opioid addiction management.
She said that users are encouraged not to be alone when using drugs so that partners can watch for negative side effects from contaminated drugs. This becomes much more difficult when quarantine or social distancing measures are in place.
To overcome this issue, users are encouraged to use an app called Lifeguard that allows users to safely use alone by automatically sending an ambulance if the user doesn’t respond to the app’s alarm. Waldron said the app has saved lives.
While the pandemic has exacerbated the overdose problem, the underlying problem of fentanyl contamination in the drug supply has worsened, Waldron said. The drug supply was highly contaminated in March, April and May, which also contributed to more deaths.
Waldron stressed the importance for employers to put procedures in place to encourage workers to come forward with substance abuse problems or concerns without having to fear repercussions or termination.