Lise Dassieu, Ph. D., research and policy analyst at the Canadian Centre on Substance Use and Addiction
Photo courtesy of Lise Dassieu
Although opioids are drugs that are typically used to manage pain, their use can also lead to serious adverse effects that can be dangerous and even deadly.
Statistics Canada reports that in 2018, 12.7 per cent of Canadians reported having used opioid pain relief medications in the previous year. Among these people, 9.6 per cent had engaged in problematic use that could cause harm to their health.
Lise Dassieu, Ph.D., a research and policy analyst at the Canadian Centre on Substance Use and Addiction (CCSA), says the nature of the construction industry makes its workers especially vulnerable to injuries leading to chronic pain and prescribed opioid use. However, she says that prescribed opioids do not automatically lead to addiction and risks.
“Construction is well-known as a physically laborious career, involving tasks like heavy lifting or performing work near hazards. As a result of work-related injury, many construction workers find themselves in need of prescription medications to address the pain or continue working in these physically demanding jobs,” she said.
Although effective for pain management and beneficial for patients’ quality of life, opioids can lead to physical dependence and present a significant health threat if used incorrectly. Dassieu says that anyone prescribed to use opioids should be aware of their potential risks and that their chronic pain should be adequately managed to prevent people from seeking pain relief in illegal markets.
There is plenty of research that outlines the impact of long-term opioid use including liver damage and brain damage due to hypoxia (or lack of oxygen) resulting from respiratory depression. These symptoms can lead to an overdose if not appropriately addressed.
Dassieu says that risks can arise as people become more tolerant of opioids and require higher dosage to achieve the same pain management. Some people may also up their dosage because their pain is insufficiently managed. People should know that this puts them at risk of overdose.
Naloxone (Narcan) kits are commonly available in local pharmacies, as they are effective in counteracting opioid overdoses. Being aware of these resources and how to access them could save a life.
Returning to work
For those returning to work, but still relying on opioids, there is a risk of impairing adverse effects including drowsiness and dizziness, and possibly withdrawal symptoms.
“A lot of people with chronic pain want to taper off their prescribed opioids due to these adverse effects that can be really detrimental in daily life. It’s also important to remember that risks associated with opioids can differ depending on your weight, the type of opioids and dosage,” Dassieu said.
There are also many alternatives available to prescription medications, which injured workers may want to consider, including physical therapies and non-pharmaceutical options.
For those who must use opioids to manage pain, Dassieu says that the healthcare system has processes to ensure patients are safely taking opioids. Doctors can help adjust dosage through shared decision-making with the patient. It is recommended that the plans are set according to the person’s needs and preferences.
Dealing with addiction on one’s own is extremely difficult. In the past, the resources available were limited and as a result, harm reduction, treatment and rehabilitation programs were scarce as well. As people become more educated on the importance of considering addiction as a health and social issue, the level of support has increased significantly.
CCSA supplies plenty of resources on their website at www.ccsa.ca for anyone looking into the first steps. The website contains a wealth of information ranging from what opioids are, to pain management to workplace fact sheets (www.ccsa.ca/workplace-safety). CCSA does not provide treatment. Dassieu says that CCSA continues to research substance use and the workplace, and will share new information on its website.
Creating a welcoming environment
An important first step for many construction companies is creating an environment where anyone can seek help and feel comfortable doing so. It is equally as important to dispel the myth that employers do not care about their workers and only want the job to get done. Substance use treatment and support programs can vary across companies. For more information, people can talk to their insurance provider.
Addictions can occur for many reasons, and employers and work colleagues need to be compassionate. Although there is a stigma attached to substance use and addictions, Dassieu says that friends, employers and colleagues can play a key role in helping an employee.
People should feel comfortable discussing this very real issue, particularly if they are struggling with addictions. Removing the perception of weakness associated with these conversations not only promotes more open discussion, but is an important step in the healing process.
“The stigma attached to people who use opioids presents big barriers to overcome because many are afraid of consequences they might face if they come forward, so instead, they do not seek help at all. Employers should know that this stigma exists, and they should train their employees to understand that substance use can happen to anyone and they are not bad people because they live with addictions,” Dassieu said.
A study using data from the Institute for Clinical Evaluative Sciences (ICES) and the office of the Chief Coroner of Ontario found that only one in six construction workers with an opioid use disorder diagnosis who died of opioid toxicity had accessed treatment in the month before their death. This statistic was significantly lower than what was observed among those with no history of working in construction.
Another relevant factor in these statistics is that most workers in this trade are male. The study found that over 98 per cent of construction workers who died of opioid toxicity between 2020 and 2022 were male, which was consistent with the gender distribution of the construction workforce in the province. Considered a blue-collar trade, the industry has left little room for mental or physical frailty.
The ICES and the Office of the Chief Coroners of Ontario Report indicated that regardless of profile, there has always been a reluctance to seek help in the male demographic – particularly for physical health, mental health and wellness in general. This means that when men find themselves in trouble, they will often avoid drawing attention to their struggles and even refuse the support or council they so desperately need. This is likely due to an inherent need to maintain a sense of independence or strength.
If you or someone you know is struggling with opioid addiction, you are not alone. There are many people and programs ready and willing to help. The Government of Canada has a website called Get Help With Substance Abuse that provides services and support resources for provinces and territories: www.canada.ca/en/health-canada/services/substance-use/get-help-problematic-substance-use.html. Do not hesitate to seek professional assistance to free yourself from opioid dependency.
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