RISK OF RELAPSE FOR ALCOHOL AND SUBSTANCE ABUSE DURING AND AFTER COVID-19
BY CAL BEYER AND KARYN SALERNO, CSDZ
COVID-19 amplified stress, anxiety and uncertainty, which has created major disruptions at work and home. As stress levels intensified, alcohol and substance use are reportedly rising significantly. Prior to the pandemic, approximately 10 percent of the United States adult population reported being in recovery for alcohol or substance use disorders according to the Substance Abuse Mental Health Services Administration (SAMHSA).
CONSTRUCTION WORKFORCE AT RISK PRE-COVID-19
According to a 2015 SAMHSA study, approximately 14.3 percent of construction workers reported substance use disorders in the prior year. Moreover, this study identified construction as the industry with the second highest rate of heavy drinking. More than 16 percent of workers reported regularly consuming five to seven drinks in a single setting. 2019 statistics from Quest Diagnostics point to higher rates of substance use among the construction workforce between 2015-2018, including:
• 13.2 percent increase in positive drug tests, including a 46.7 percent increase in positive tests for marijuana.
• 40 percent higher cocaine use than the national average for all other 16 industries analyzed
• Methamphetamine use 30 percent higher than the national average.
RISING RISK DURING AND AFTER COVID-19
As physical distancing requirements banned group assemblies, many group recovery meetings were forced to stop gathering in person. As COVID-19 disruptions continued, persons in recovery from alcohol and substance use disorders faced increasing isolation and lack of group support. This threatened the sobriety of many employees and family members who are in recovery. These vulnerable people risk experiencing a relapse if they cannot find a connection to online recovery meetings. Drug overdoses have been increasing dramatically since the start of COVID-19 pandemic.
Lines for Life in Portland, Oregon, is a crisis hotline focused on substance use disorders and suicide prevention. CEO Dwight Holton is a former federal prosecutor who grew weary of incarcerating people struggling with addiction and other mental health conditions. Holton says “COVID created a special strain on folks struggling with mental health and substance abuse challenges. We are working to build industry-specific efforts to provide hope and support to keep people safe on the job.”
Mandi Kime, director of safety of the ACG of Washington, has been an active proponent of reducing the stigma associated with mental health, addiction recovery and suicide prevention. Kime states “It has taken decades to overcome this stigma. Many companies have invested in robust safety and substance abuse programs to combat the dangers and deaths related to drug use.” Kime also states the “the problem has hit new levels because people don’t necessarily start on drugs to ‘get high,’ they may start to combat pain from injuries, and then that use devolves into addiction.”
ENCOURAGING AND SUPPORTING WORKERS TO SEEK HELP
Dana Hohn Strange, human resources director for LPR Construction in Loveland, Colorado, a member of AGC of Colorado Building Chapter member, states “mental health remains a top focus in our targeted wellness and overall well-being communication.” LPR uses data from “Employee Assistance Program (EAP) utilization reports and self-funded health insurance claims reports to develop strategies on where to focus communication based on top health concerns among our employees.” Strange continues “if we see high opioid prescription numbers, we focus social media campaigns and toolbox talks on pain management and resource availability, such as the EAP.”
Lines for Life’s Holton asserts the “COVID crisis has exposed the challenges we face in industries like construction that attract independent, tough and self-reliant folks. We need these folks to know it’s okay to reach out for help; it’s not a weakness, it’s normal.” Holton states “nobody who breaks an arm is reluctant to go to the doctor. But when folks are struggling with substance misuse or mental wellness, they are reluctant to get help. We need to reduce barriers to care seeking.”
LPR Construction’s Strange shares a success strategy in helping the workforce open-up to the possible need for help. She says “one resource we’ve gotten positive feedback on is www.mantherapy.org, a free website that puts a humorous spin on men seeking health for managing stress, substance abuse, grief, depression and anger.” Strange said “we have socialized the Man Therapy website as a resource at LPR. I have heard from numerous people that it is helpful and that they recommend it to others.”
Rich Thorn, president/CEO of the AGC of Utah, challenges its members: “As employers who care about our people, we urge you to embrace these challenges. Don’t’ run and hide or turn a blind eye. Let your people know that you care and are there to help.” Thorn continues “they are the ones that make things happen. These employees are not just employees, they are fathers and mothers, sons and daughters, and most importantly our friends.” Thorn states “don’t be afraid to ask the tough questions of how they and their families are feeling and then respond in a supportive and understanding way. As an industry we ‘figure things out,’ and we’ll figure this challenge out as well.”
RECOMMENDATIONS FOR CONSTRUCTION EMPLOYERS:
1. Recognize the limitations of substance use testing as a deterrent amidst the rising rates of substance use and overdoses.
2. Increase vigilance for signs of reasonable suspicion by operational supervisors and safety staff. Impaired workers increase the risk of poor jobsite safety and quality performance.
3. Teach operational leaders about available EAP services and teach them how to coach an employee on using the EAP for substance use and other stressors.
4. Share information with employees regularly about your company’s — or union’s — EAP and the services available to employees, family members and dependents.
5. Display posters with the SAMHSA Helpline number to help employees recognize that help is available to find treatment options.
6. Conduct Toolbox Talks on Substance Use and the EAP.
• Include videos from Man Therapy website (www.ManTherapy.org) in the Toolbox Talks.
• Provide information to employees on Virtual Recovery Meetings: http://www.csdz.com/wp-content/uploads/2020/05/Toolbox-Talk-Mental-Wellbeing-Risk-of-Alcohol-or-Substance-Use-April-2020-.pdf
7. Participate in joint labor management training with signatory labor unions to discuss prevention strategies to help bring awareness to the jobsite.
8. Coordinate a Substance Use Stand-Down with all contractors on your company’s projects.
9. Consider securing Naloxone/Narcan for jobsites if it is legal in your jurisdiction and if the company has reason to believe workers are taking opioid medications for any reason. Narcan reverses the effects of opioids.
Strange worries about the “silent sufferers. If they come to work, have a great work ethic and can maintain that but are not reaching out, what will reach them?” Her concern is “if they are already at the breaking point, even if front line managers are doing a good job of communicating our initiatives, will we reach the people that need it most?” Strange optimistically states “hopefully their issues are apparent so we can reach them if they aren’t getting help elsewhere.”
Cal Beyer, CWP, and Karyn Salerno work for CSDZ, a Holmes Murphy company and an AGC of Greater Milwaukee member. Beyer is vice president of workforce risk and worker wellbeing and was instrumental in launching the mental health and suicide prevention movement in the construction industry. Reach Beyer at email@example.com. Salerno is a risk and safety specialist with over 25 years of experience in safety and risk management. She is partnering with contractors and associations in the western United States to address physical safety and behavioral health issues. Reach Salerno at firstname.lastname@example.org.
Bush, D., and Lipari, R. (April 16, 2015). Substance Use and Substance Use Disorder by Industry. https://www.samhsa.gov/data/sites/default/files/report_1959/ShortReport-1959.html
Quest Diagnostics. (September 11, 2019). Workforce Drug Positivity Increases in More Than One-Third of U.S. Industry Sectors Examined, According to Quest Diagnostics Multi-Year Analysis. https://www.questdiagnostics.com/home/physicians/health-trends/drug-testing/industry-insights/
Science Daily (October 30, 2019). Of all professions, construction workers most likely to use opioids and cocaine. https://www.sciencedaily.com/releases/2019/10/191030082825.htm