‘Construction and opioids go really well together’: One industry’s battle with drug addiction
Logan Carroll started drinking at 12, smoking weed at 13 and was doing cocaine in high school.
His love of oxycodone began when he got his wisdom teeth out at age 16 and tried Percocet for the first time.
He became an IV drug user at 19, injecting heroin and, later, after he moved out west from Ottawa, “purple putty” a dangerous mix of drugs including the potent opioid fentanyl.
But it was while working as a general labourer that his addiction to hydromorphone, methadone and fentanyl flourished.
“Construction and opioids go really well together,” said Carroll.
“At the beginning when I was using hydromorphone, I was better at my job. I was more consistent. I enjoyed working more because I felt good. Nothing mattered. Even if I was doing something I didn’t want to do if I was on opioids, it made no difference, you know?”
The St. Mark High School grad is thin and healthy looking, well-groomed with his brown hair swept back and his beard neatly trimmed. He tells his harrowing story of drug use, overdosing and recovery honestly and openly over a lunchtime burger at a Barrhaven restaurant.
“In the recovery world, there’s a lot of anonymity and hiding, people getting well and then not talking about it. I don’t agree with that,” he said. “I’ve talked about it many times. It’s more helpful than it is damaging.”
He explains how drugs allowed him to soldier on through whatever gruelling job he was doing at the time: landscaper, sheet metal worker, parts puller at an auto wrecker.
“I started to attribute me being good at my job with me being on drugs.”
He came back to Ottawa from the west in 2016. His mother is terminally ill. His father, the primary caregiver, had suffered a stroke, though he has since recovered. His older brother has cerebral palsy. For a time, Carroll was the primary caregiver to all three.
Carroll survived his addiction and has been in recovery since October 2016. He still works as a labourer, clearing snow in winter, landscaping and laying interlock brick in better weather. Sober and saving money that used to get sucked up by his addiction, he has plans to set up his own landscaping company in Ottawa.
He’s one of the lucky ones.
I started to attribute me being good at my job with me being on drugs,” says Logan Carroll. Jean Levac JEAN LEVAC / POSTMEDIA NEWS
Few occupations are as vulnerable to opioid addictions — and rocked by overdose deaths — as construction workers and general labourers. A report last fall by the BC Coroners Service found 55 per cent of that province’s overdose deaths were workers in the construction and transportation industry. A 2018 study by the Massachusetts Department of Public Health found that construction workers in that state were six times more likely to die of opioid overdose than any other occupation.
It’s a trend that’s being seen across North America, said Arlene Dunn, deputy director of Canada’s Building Trades Union, which represents more than 500,000 construction workers and skilled tradespeople in Canada.
“It’s just the nature of the jobs we do,” Dunn said. “Heavy-duty work that takes its toll on the body — lifting, climbing — heavy work that’s prone to injury.”
That pressing need to work through the pain, be it physical or psychological, is what puts labourers at such risk in the opioid epidemic.
“Look at construction sites and see some of this happening,” she said. “Construction work opportunities are usually short. Typically, our folks go to a job site, try to get as many hours as they can, then go on to the next job.
“Unfortunately, when they do get hurt on the job, they go to their family physician or an emergency clinic, grab something for pain, then go back to work.”
The death toll from Canada’s opioid epidemic is staggering. The Public Health Agency of Canada reports more than 9,000 Canadians died from overdose deaths between January 2016 and June 2018. In B.C. alone, 1,489 people died of illicit opioid overdose in 2018. That’s more than four people a day.
B.C. leads the way when it comes to tracking and reacting to opioid deaths, but what has happened on the West Coast is quickly spreading east.
“It’s staggering when you look at the small provinces and see how quickly the numbers are catching up to the larger provinces,” Dunn said.
While the emergence of fentanyl — a synthetic opioid 100 times more powerful than heroin — has made the problem deadlier, the use of narcotics in the construction industry is nothing new. It appeared on Dunn’s radar some 15 years ago, when the union discovered it was paying an enormous bill for pharmacy dispensing fees through its health plan.
“What we noticed is we had one particular pharmacy where we had spent $1.8 million in one year just for one construction union in prescription fees. We said, ‘This doesn’t seem right. Something is wrong.’ When we tracked it, we found out that it was for methadone.”
The fees were high because someone on methadone must go to the pharmacy every day to get their prescribed dose. Dunn began to wonder if the construction industry had a drug problem. But methadone use only shows people who have received treatment for their addiction and taken the step to get help, using methadone as a treatment to ease their cravings. It is the tiny tip of a very large iceberg.
Many trades workers’ and labourers’ first encounter opioids as a prescription for pain from their family doctors. Opioids such as oxycodone are a quick fix that will get someone back to work faster. That’s something that workers look for in an occupation where the hours are long and contractors race to meet strict construction deadlines. Many employers offer little in the way of health benefits and little in the way of compassion for those struggling with health issues, whether the pain is physical or psychological.
“A lot of people are using opioids for physical pain, but a lot of people are also using them for psychological pain,” said Fardous Hosseiny, national director of research and public policy for the Canadian Mental Health Association. “These are people who are struggling with depression or anxiety or PTSD.”
Wait lists for mental-health care can stretch six months to a year or more, meaning many of those suffering turn to drugs or alcohol to self-medicate.
That’s a particular problem in the construction and trades industry because the profession is overwhelmingly male and steeped in macho-culture. Roughly three-quarters of all opioid overdose deaths in Canada are men.
“It’s a deemed a macho industry where guys don’t talk about their pain and don’t say that they’re ailing. That could be seen as a weakness. I think that’s really unfortunate,” Dunn said.
“You have a male in his 50s. We figure that guy’s got it all figured out. He’s toward the end of his career. He’s white and the typical middle-class guy, we don’t have to worry about him. That’s the forgotten population.
“They’re going through a lot, too, and in the construction industry, we see a high rate of suicide, which is tied to substance abuse, which is tied to mental health. They’re all connected,” she said.
In fact, a 2015 study by the Centers for Disease Control found the construction and extraction industry had the highest suicide rate of any profession surveyed, with 52.1 deaths per 100,000, a rate 200 per cent higher than U.S. national average.
Recognizing the problems is one thing, but what can be done to lower the risk for construction workers and opioids?
For Dunn, it starts with doctors who are willing to explore alternative treatments for pain.
“It’s not good to just tell physicians to stop prescribing opioids,” she said. “We know that’s not the answer because we’re driving those members who are in the throes of opioid dependencies to the streets. That’s where they’re picking up pills that are laced with fentanyl. That’s why they’re dying.”
Another need is to educate workers about the dangers of opioids and for them to be wary of the quick fix of popping a pill.
“We’re creating brochures that our members can have in their pockets so that when they go to their doctor or an emergency clinic, they can say to the doctor, ‘Hold on. Before you give me a prescription for opioids, look at this. Can you give me something that’s different?
“Some of our folks don’t self-advocate very well. They may just assume that because that person is a physician, they have the right answers.”
Alternative therapies such as meditation have proven effective at controlling pain, although it requires more work and more time than a pill.
Employers, too, have to be more understanding of their employees’ needs, particularly around pain management and mental health. Even workers who are being treated for their addiction can be scared to admit that to their employer, Dunn said.
“We had a job site where we had some individuals who were on methadone. They were in treatment for opioid addiction. And the contractor called me up and said, ‘Look. These individuals are going to be working in forklifts and working at height and they’ve self-disclosed as being on methadone. He said, ‘We can’t have them on the job. They’re just replacing one high with another.”
Though Logan Carroll frequently worked with other drug users — at one company, every worker, even the employer, was in recovery. But more often than not, he said, he felt alone in his addiction.
“I never brought it up. I guess that’s where stigma came into play. If I had been able to tell my employer what was going on, things might have been different,” Carroll said.
“Most Canadian workplaces that have substance-abuse policies favour disciplinary measures rather than supportive measures,” said Hosseiny of the CMHA. “Instead of paying for treatment, they’re actually disciplining them.”
Making workers fearful of admitting their addiction or seeking methadone treatment can drive them toward street drugs and the dangers of overdosing on a supply contaminated with fentanyl or other synthetic opioids.
“We need to create an environment that fosters them to be able to come out and say, ‘I need help,’” Hosseiny said.
“(Employers) should be able to say, ‘Here is a four-week leave and we’ll support you in that.’ They shouldn’t be forced to come into work. We don’t do that with cancer. Why are we stigmatizing people struggling with mental illness?”
In fact, the CMHA is urging Canada to follow Portugal’s lead, which in 2001 decriminalized all drugs.
“The war on drugs is not working,” he said. “We see that year after year. Problematic substance use is like any other disease and should be treated as a health concern and not treated as a criminal justice concern.
“We’re not saying decriminalization is a silver bullet — because there’s a bunch of other recommendations we made. The other big one is investing in mental health services, increasing access to services so that people can see a psychologist when they need to. We know that untreated mental illness over time gets worse and worse.”
Logan Carroll’s long road back from addiction came from a family friend, someone whose background was in addiction treatment and had watched his long downward spiral.
“I was just being polite,” he said. “Someone asked me if I wanted to go in treatment and I was like ‘Oh, sure.’ She took all the steps that I needed to take and got me on a plane. I didn’t know at the time that she was in that world. She understood what was going on more than I did. When she felt I was ready, she made the offer and I was in recovery.”
“I’d lost all my jobs. I’d lost my girlfriend. I could hardly get out of bed. I was ready to die. I felt like I had lost everything and lost my purpose and nothing mattered anymore. And I was broke, that didn’t help. I just said yes. Against my instincts, I said yes I’d go to treatment even though everything in my body said I couldn’t do it.”
He went to a residential treatment centre in Calgary for four months then spent another month under supervision in an apartment co-leased with the treatment centre. Even so, he had a near-fatal relapse in July 2017.
“The first time I used in Calgary, I overdosed pretty badly,” he said. “I used heroin mixed with fentanyl, and I’d never done it before. I didn’t really care anymore, because I’d decided this was what I wanted to do. And as soon as I did, all the cares in the world ended and I just kept going and going and going until I overdosed.
His girlfriend at the time, also a drug user, saved his life.
“Luckily she was there. She gave me the CPR the whole time. She gave me two Narcan kits. Then the ambulance got there and they gave me two more and a shot of something else and I pulled up, luckily.”
He’s been sober since Dec. 15, 2017.
Since then he’s been fearless and brutally honest about his drug use and its dangers. He appeared on a panel discussing the stigma of drug addiction at Health Canada symposium on opioids in Toronto last September.
Though sober, he still feels the lure of opioids, particularly hydromorphone and fentanyl.
“That was my go-to drug. It’s still my go-to. People have a misconception that it’s a choice, once you get clean, to go back to drugs. But that’s my answer to all my questions. When something hard happens, I think, ‘Oh, I know how to fix that.’”
Recovery began when he accepted that he needed help and that he couldn’t do it on his own.
“Start saying yes to people who can help you. I was, ‘I got myself into this on my own. I can get myself out.’ But that’s just so wrong and so misguided. I just decided I didn’t want to do this alone anymore. It’s not a weakness to ask for help,” he said.
“And people did care about me. As much as I didn’t care about myself, they still loved me. That’s crazy, but it happened.”
Opiate vs. Opioid: Opiates such as heroin, morphine or codeine are naturally derived drugs from the flowering poppy plant. Opioid is a broader term covering both natural (opiates) and synthetic drugs that bind to the brain’s opioid receptors. Synthetic drugs include oxycodone, hydromorphone, fentanyl and methadone.
Oxycodone vs. OxyContin: Oxycodone is a highly addictive, synthetic opioid used as a painkiller in brand-name drugs such as Percocet and OxyContin. OxyContin is a time-released version of oxycodone. OxyContin was approved for use in the United States in 1995 but proved to be so addictive that the U.S. Food and Drug Administration banned its original formulation in 2013. The drug is no longer marketed in Canada.
Hydromorphone is a highly addictive, synthetic opioid used to treat moderate to severe pain such as experienced by cancer patients. Dilaudid is a common brand name of hydromorphone.
Methadone is a synthetic opioid that mimics the effect of other opioids such as heroin or morphine. The drug stays active in the system much longer than other opioids, so the onset of opioid withdrawal is delayed, the withdrawal lasts longer and the symptoms less severe. It is used to help opioid users detoxify and can help them reduce or end their dependence on drugs.
Fentanyl is synthetic opioid developed in 1959, originally for use as an anaesthetic. The drug is highly addictive, however, and 100 times more powerful than opioid. It becomes a popular choice for illicit drug users after governments began banning OxyContin in the early 2010s.