Jobs in the trades are stressful and physically demanding, far too often resulting in injury, pain and mental health issues. Using drugs and alcohol to relax after long shifts and to cope with pain can lead to further problems both at work and in personal lives. Top this off with not talking about substance use or mental health problems often out of fear of losing their jobs, and trades workers are unlikely to ask for help even when they need it.
It’s a devastating issue that the Canadian Centre for Occupational Health and Safety (CCOHS) is tackling with its recent launch of a suite of practical resources aimed at supporting health and well-being in the trades, including the prevention, management and treatment of substance use. Developed in collaboration with the Canadian Apprenticeship Forum (CAF), these free resources include online courses and info sheets available to employers and tradespeople all across Canada.
Between August 2022 and April 2023, with funding from Health Canada, CAF commissioned a Canada-wide survey of 1,194 people, mostly apprentices and journeypersons, in an effort to understand their lived experiences in the trades.
“They wanted some actionable items and tools to give workplaces to create awareness of substance use and reduce stigma,” said Jan Chappel, senior technical specialist with CCOHS. “We partnered with them to develop the program Substance Use in the Trades using a client-centred approach, trying to reduce the health and social harms associated with addiction or substance use. The person doesn’t necessarily have to stop using the substance, rather they try to find a safer way to approach it.”
This harm reduction approach maintains that people who use substances deserve dignity and respect, and have the right to make their own choices.
“We take the ‘Fit to Work’ approach, taking it all into perspective – what does the workplace need? It’s all about being able to do the job safely,” said Chappel.
Many aspects of the workplace require alertness, accuracy and quick reflexes; impairment to these qualities can cause incidents and interfere with the accuracy and efficiency of work.
There can be many reasons for impairment including substance use, fatigue, stress, distractions and mental health. Additional risk factors may include heavy manual labour, working at heights or working with vibrating machinery. Working with difficult forepersons and co-workers, long work hours and pressures at home may also impact workers.
In an effort to clarify the issues and offer solutions, Substance Use in the Trades focuses on several important themes aimed at bringing awareness to substance use and harm reduction. The online program is made up of three components that take about 15 minutes each to complete.
Being aware
Understanding substance use and the impacts of stigma form the base of this course. Common substances used are alcohol, cannabis and stimulants, including prescription drugs. Twenty-five per cent of those surveyed said they use substances to cope with anxiety or depression. Others said they use substances to cope with work-related stress or to improve their performance at work, while the use of prescription opioids was mainly for pain management.
“Another important area we look at is reducing the barrier of stigma,” said Chappel. “We know that attitudes towards substance use can make people approach the situation in a way that is not positive or helpful. Remember that people are struggling with substance use. It’s not always a choice, a moral failing or a weakness. So remove that stigma and ask them ‘Do you need some help? Let me find you some help.’”
The course clarifies that stigma arises when individuals view either others or themselves negatively due to substance use. Self-stigma encompasses the attitudes and beliefs individuals hold about themselves, which may include fears of being perceived as weak, a failure or disappointing others. Social stigma pertains to societal beliefs or attitudes that disapprove of certain behaviours. Structural stigma relates to organizational rules, policies and practices that stigmatize individuals who use substances.
Almost half of the 1,194 survey respondents said they would be afraid of the consequences at work if their supervisor found out about their substance use, and almost a third agreed with the statement that they would be afraid of their friends or family judging them.
Strategies to reduce stigma in the workplace focus on the person, their physical safety and mental health rather than the substance use.
“Whether your concern is for yourself or for someone else, it takes courage to have open conversations and change attitudes. Reducing stigma improves physical safety because people may be more likely to report if they, or someone else, is impaired on the job,” said Chappel.
Harm reduction
This course discusses the features of a healthy workplace and approach to substance use. A safety program to eliminate workplace injuries is essential to avoid the potentially chronic and out of control use of pain meds, but a workplace culture of long hours, deadlines and negative comments can contribute to stress that workers take home, deteriorating mental health.
A healthy workplace fosters positive communication and open conversation and develops policies that encourage people to seek help without feeling stigmatized.
Harm reduction is an ongoing process. Employers can provide support through employee assistance programs to help workers with personal challenges and find ways to enable workers to safely self-declare they may be impaired. Employers can ensure available benefits are adequate and flexible for workers who need help. Further, employers must understand that abstinence may not be realistic or helpful, and that opioid maintenance therapy and treatment should be accepted in the same way as medications for anxiety, depression and other mental health issues. For many workers, suddenly stopping substance use would cause harm, while gradually reducing use over time may be more effective. Consider each individual situation and be aware that workers may continue to use substances and still be safe to work.
“We do harm reduction every day we put on a seat belt or a bike helmet,” said Chappel. “The hazard still exists, but you’re taking steps to reduce the harm that may come from an incident.”
Strategies include offering free taxi rides home from work-sponsored events to prevent drinking and driving, providing a time and place where people can talk openly about their issues without fear of getting fired, or having a designated person who people can go to without fear of judgement.
Although primarily aimed at supervisors and employers, this course carries the bottom line that everyone has a responsibility to address substance use in a way that reduces harm.
Supporting well-being
Not all substance use is cause for concern, but it is important to recognize how substances can affect mental and physical health. Sometimes regular use of substances can change brain function and structure. All workers can be trained to eliminate stigma, to recognize signs of impairment and to respond accordingly.
Health Canada lists signs that someone may be struggling with substance use and perhaps need help or someone to talk to. Changes in personality, extreme shifts in behaviour and mood and isolating from friends and family are indicators that harm reduction is needed. Perhaps the person has trouble remembering things, concentrating or staying alert. They may have difficulty managing basic parts of their life due to increased drug and alcohol use.
The course emphasizes that whether someone is concerned about their own substance use or that of someone else, it’s okay to ask for and to offer help. Starting a conversation can be uncomfortable but it shows caring and commitment.
“Looking after ourselves as well as others is not a sign of weakness,” said Chappel. “It’s strength. It takes courage to reach out and get the right supports.”
All three Substance Use in the Trades courses are available online at ccohs.ca at no cost or obligation.