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The Opioid Use Disorder: Epidemic in Construction
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The Opioid Use Disorder Epidemic in Construction
SMART and SMACNA join forces to defeat this powerful enemy
By / Deb Draper
Every day in the United States, at least 115 people die from an opioid overdose—that is 42,000 per year. Furthermore, a recent survey from the U.S. Departmenr of Health and Human Services (DHHS) reported that 2.1 million Americans have an opioid use disorder (OUD). In 2017, the US Department of Health & Human Services declared OUD to be a public health emergency. How did this happen?
In the late 1990s, pharmaceutical companies assured medical communities around the world that opioids were not addictive, and prescriptions increased dramatically. However, long-term opioid use decreases the pain-reducing effects, higher doses are needed to keep up with growing chronic pain, and this leads to physical dependence and risk of overdose.
It is estimated that one out of every four patients prescribed opioids will go on to misuse them to some degree. Half of those patients will develop OUD. Half of those again eventually transition to heroin. This epidemic of misuse affects everyone, in every walk of life. This is especially true for in construction, which has one of the highest injury rates of any other industry, reaching 77% higher than the national average, according to Midwest Economic Policy Institute research.
Mike McCullion, director of SMACNA’s Market Sectors and Safety, sees the opioid crisis as, in many ways, a case management and communication crisis. Generally, the focus on the physical injury and attendant pain relief fails to take in the larger issues of the injured dealing with downtime and unknown, latent, or recurrent addictive and dependency issues.
“Often workers will get the drugs, and then sit at home and dwell on their situation without interacting with the outside world, including the employer,” McCullion says. “Unable to deal with these growing issues and seemingly overwhelming mental traps, they may turn to other escape mechanisms of available drugs and alcohol, and an often a fatal spiral begins.”
In order to offer an effective, healthy recovery plan, physicians need to know what a worker’s job entails or if there will be drug testing at work—some prescription opioids can mean losing a job. With realistic information and up-todate education on individual drugs including opioids, they can offer alternative medications, using opioids only for the very short term.
McCullion believes that proper guidance and health care management must be part of an overall injury case management program to get injured workers healthy and back on the job again. “The reality is that anyone who takes prescription opioids can become addicted to them, but those who have addictive tendencies are at even greater risk to misuse opioids.”
Even when patients take the prescribed dosage of an opioid, if they add alcohol, sleeping pills, or anti-anxiety meds, their breathing may simply stop. Respiratory depression is the chief hazard associated with opioid painkillers. A report by the Massachusetts Department of Public Health found that nearly one-quarter of overdose deaths across a five-year span occurred among construction workers.
Opioid Use Disorder
“Our industry is physical by nature and people do get hurt on the job,” says Chris Carlough, SMART’s Director of Education. “The problem with opioids is that they are powerful and highly addictive, some more than others. We have the second highest addiction rate of any industry—16% of construction workers have a predisposition to being addicted.
“Powerful drugs like these actually hijack our natural reward system. Once we understand that addiction is a disease of the brain, we can support ourselves and each other during these struggles,” he adds.
Studies have shown that opioids are often not more effective than other oral medications for relieving pain. Injured workers need to understand that there are alternate means of pain management. They need to talk to their healthcare provider about options, other non-medical treatments, and reactions to medications they may already be taking.
“We need to reinforce to our members that when they get hurt on the job, they need to take precautions about medications,” Carlough says. “There are different types of opioids—all very strong. But there are alternative means of pain management that are not addictive.”
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McCullion sees this as where the healthcare provider and employer can come together. “Regulatory-wise, as soon as an injury occurs, the employer is immediately involved, but there are further ways to help,” he says. “They can educate the worker on rights and responsibilities in the process and enable them to see the doctor, as needed, to ensure they are following their recovery program that they aren’t misusing the prescribed drugs.”
Many employers already have relationships with healthcare providers, letting them know what type of work the patient does and looking to get them back on the job as soon as possible, even if it means light duties for a while.
“With the employer, healthcare provider, and worker all on the same page, we can get our people through the recovery process and back on their feet as healthy as possible,” McCullion says. “This means coordinating a team effort of managed care and attentive communication. Employee assistance programs (EAP) are becoming more available and more useful as they address a number of issues, including depression, suicide, and opioids— talking about these things in open forums, removing the stigma.”
Carlough recalls, “About five years ago, thinking about substance abuse, we added a section into a SMART advanced representation class on how to represent our members who are going through crisis. The response was overwhelming and the level of participation kept increasing,” he says.
This enthusiasm led to the development of the SMART Members Assistance Program (MAP) in conjunction with the International Training Institute (ITI) and the Sheet Metal Health Institute Trust (SMOHIT) and jointly funded by SMART and SMACNA.
“We are presently engaged in peer mentorship around this important issue, training SMART MAP mentors who are compassionate, empathetic, and well-respected union members who continue to support our members when returning to the workplace,” Carlough says. “This will be the fundamental element in our success with helping our members and their families.”
SMART MAP focuses on the mental health of members and their families by providing training on awareness, solutions, and support, highlighting substance use disorder and suicide prevention. “
SMACNA is promoting the MAP program in October in Alexandria, Virginia, and Chris Carlough is a conducing a MAP session at the SMACNA Annual Convention,” McCullion says.
It all comes down to education, understanding the risks, and developing a culture of caring on every level of industry. No one chooses to become addicted. By looking out for each other, working as a team in every sense, and learning how to get help and follow through, everyone comes out a winner in the battle against substance abuse. ▪
From her desk in Calgary Alberta, Deb Smith writes for trade and business publications across North America, specializing in profiles and stories within the mining, recreation, and construction industries.
Chris Carlough Making a Difference One Step at a Time
A proud member of SMART for almost 35 years and Director of Education since 2007, Chris Carlough works hard for members, representatives and contractors in the unionized construction and transportation industries. The SMART Department of Education team strives continuously to improve all educational programs for its members and their representatives, and Carlough has made it a further mission to develop a network of support for members and their families facing substance abuse, mental health issues and suicide. Drawing upon personal experience with addiction and recovery, he has organized peer support training across North America through SMART MAP training initiatives. Carlough is proud of his union’s commitment to developing a caring network of union members who can offer guidance and support for those going through substance use disorder. He is passionate in his belief that a culture of caring brings a positive difference to the quality of life for everyone in the labor movement.
Chris will be speaking at the 2020 Partners in Progress conference held in Las Vegas February 25 and 26. Keep an eye on future issues for more information on speakers and events. Registration will open in September 2019.
