Runtime: 38:05
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SHOW NOTES
Summary
In this episode, journalist David P. Ball and occupational addiction medicine physician and supreme court expert Dr. Deborah Kason discuss how to navigate substance use care for people working in construction and other safety-sensitive jobs. This includes workers who can cause significant harm to themselves, others, or property, if work is not performed in a safe manner. They also speak with Greg Hemminger, who coordinates a harm reduction education program for construction workers called the Tailgate Toolkit and brings his own lived experience of opioid addiction and recovery. And for a clinical perspective, they speak with addiction and occupational medicine physician Dr. John Koehn on how he helps his clients re-enter the workplace safely, and the power of relationship building in this area of medicine.
Learning Objectives
- Define safety-sensitive work and identify potential harms related to substance use in the construction, trades, and transport industries.
- Discuss potential contributors to substance use among people working in construction.
- Identify substance use care approaches for workers in safety-sensitive jobs that balance client well-being and workplace safety.
Lineup
In this episode, you’ll hear:
- 2:23 – Dr. Deborah Kason, Co-host – Family physician and qualified expert in the BC Supreme Court in occupational and addiction medicine
- 8:17 – Greg Hemminger, Guest – Tailgate Toolkit Coordinator, Vancouver Island Construction Association
- 20:44 – Dr. John Koehn, Guest – Addiction medicine physician, Royal Columbian Hospital
Clinical Pearls
Here’s what listeners can take away from this episode:
- It’s important for clinicians to consider what their client does for a living before prescribing opioids or treating opioid use disorder. Ask your client if they are employed and what they do for work early and often and have open conversations about how their substance use may be impacting their own or others’ safety. Understand that treatment and care for this population will be nuanced due to the potential for harm related to effects of substance use (e.g., sedation from opioids).
- Be aware that employers have a duty to accommodate, meaning they must take all reasonable steps to allow the person to do their job, to the point of undue hardship. In the case of substance use and construction, this means the employer should take all reasonable steps to accommodate an employee with a substance use disorder, as long as they are not impaired during work and are not posing a risk to themselves, others, or expensive equipment. Doctors have a role in advising on limitations. For example, they might recommend their client who has stabilized on opioid agonist treatment return to work on desk-based duties.
- There are many useful resources related to safety sensitive work and substance use. For people working in construction, the Tailgate Toolkit is a great resource for reducing harms related to substance use, knowing your rights as an employee, and accessing care. For care providers in the community, there are resources like the RACE line and BCCSU 24/7 line to help provide consultations related to substance use care planning for your clients. Check out the resources below.
Resources
Supports for individuals in construction/trades or other safety sensitive work
- Tailgate Toolkit
- CCSA Toolkit: Substance Use and the Workplace: Supporting Employers and Employees in the Trades
- Opioid Treatment Access Line: 1-833-804-8111 (0900-1600 seven days a week)
Supports for care providers
- Rapid Access to Consultative Expertise (RACELine) – Addiction Specialists: 1-877-696-2131 or 604-696-2131 (0800-1700 Monday to Friday)
- 24-7 Addiction Medicine Clinician Support Line: 778-945-7619
Reports, statistics, and guidance
- [Cited in the episode] Gomes T, Iacono A, Kolla G, Nunez E, Leece P, Wang T, Campbell T, Auger C, Boyce N, Doolittle M, Eswaran A, Kitchen S, Murray R, Shearer D, Singh S, Watford J. Lives lost to opioid toxicity among Ontarians who worked in the construction industry. 2022.
- B.C. Ministry of Mental Health and Addictions. Construction Industry Roundtable on the Opioid Overdose Crisis – August 27, 2018: Summary Report September 2018. 2018.
- Bush DM & Lipari RN. The CBHSQ Report: Substance Use and Substance Use Disorder, by Industry. 2015. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Rockville, MD.
- Canadian Human Rights Commission. Impaired at work: A guide to accommodating substance dependence. 2017.
- Fraser Health Authority. Policy: Alcohol and Drug Use. Corporate Policy, Standards, and Procedure. 2014.
- Fraser Health Authority. Supporting recovery through Return to Work: Approaches for workers with mental illness and substance use issues in British Columbia’s construction industry. 2020.
- Farnan P, McPherson C, Moniruzzaman A, Rezansoff SN, Sobey P, Somers JM. Construction Safety and Substance Use: Blueprint for Action in BC. 2023. Simon Fraser University, Vancouver BC.
- Government of Canada. Men in trades and substance use. 2023.
- Ministry of Mental Health and Addictions. Escalating BC’s response to the overdose emergency. 2018.
- Special Advisory Committee on the Epidemic of Opioid Overdoses. Opioid- and stimulant-related harms in Canada. Ottawa: Public Health Agency of Canada. 2022.
- Statistics Canada. Drug overdose crisis: Socioeconomic characteristics of those dying of illicit drug overdoses in British Columbia, 2011 to 2016. November 13, 2018. Accessed December 10, 2024.
Articles
- Chu K, Carrière G, Garner R, Bosa K, Hennessy D, Sanmartin C. Exploring the intersectionality of characteristics among those who experienced opioid overdoses: A cluster analysis. Health Reports. 2023;34(3), 3-14.
- Dale AM, Buckner‐Petty S, Evanoff BA, Gage BF. Predictors of long‐term opioid use and opioid use disorder among construction workers: Analysis of claims data. Am J Ind Med. 2021 Jan;64(1):48-57.
- Frimpong S, Sunindijo RY, Wang CC, Boadu EF, Dansoh A, Fagbenro RK. Coping with Psychosocial Hazards: A Systematic Review of Young Construction Workers’ Practices and Their Determinants. Buildings. 2023; 13(1):22.
- Ompad DC, Gershon RR, Sandh S, Acosta P, Palamar JJ. Construction trade and extraction workers: a population at high risk for drug use in the United States, 2005-2014. Drug Alcohol Depend. 2019;205(107640).
- Xiuwen SD, Brooks RD, Cain CT. Prescription opioid use and associated factors among US construction workers. Am J Ind Med. 2020 Oct;63(10):868-77.
- Xiuwen SD, Brooks RD, Rodman C, Rinehart R, Brown S. Pain and prescription opioid use among US construction workers: Findings from the 2011‒2018 Medical Expenditure Panel Survey. Am J Public Health. 2022 Feb;112(S1):S77-87.