L2B Webinar: Opioid Epidemic Hits Construction Hard
With opioid overdose cases rising across Canada, and in the construction industry in particular, there has never been a better time than now to include naloxone kits in construction site first-aid kits.
That was the message that Mark Barnes, the owner of RespectRX Pharmacies, and a leader in establishing programs for the opioid crisis, delivered to attendees at the latest Link2Builkd webinar on September 30.
Barnes’ experience with opioid overdoses and the community health crisis that is being created by such derivatives as fentanyl and carfentanyl dates back more than 10 years when he stopped his work as a community pharmacist to focus on helping people with addictions. Today RespectRX Pharmacy not only operates five brick-and-mortar locations in and around Ottawa, but also conducts community outreach work to reach addicts where they live, and where their use of opioids and other harmful substances put them at risk.
He has understandably seen the rate at which the epidemic of opioid use has grown in the past 10 years, and in particular since the COVID-19 pandemic.
“There were more than 6,200 deaths from opioids in Canada in 2020, and 96 percent of those were accidental or unintentional,” he said. “Of those deaths, more than 2,400 were in Ontario—that’s up from a little over 1,500 in 2019—with 350 in December alone.
“The COVID-19 pandemic created fear, anxiety and isolation among all of us,” he added. “Imagine how much worse that situation would be for someone with a history of mental health problems or of substance mis-use.”
10,000 times stronger than 10 years ago
Opioids have a complicated history. Used properly in modern medicine, they are powerful tools for sedating patients for surgery or managing pain and discomfort. In that sense, said Barnes, they’re not at all bad things.
On the streets, they’re a different animal altogether. Until recently, heroin was the most popular street opiate, but that drug is increasingly being replaced by the easier-to-produce and far more powerful fentanyl. Fentanyl is approximately 100 times more powerful than heroin. Its various derivatives, like carfentanyl, are 100 times more powerful than fentanyl—and are often produced in street labs.
“That means that the toxic drug supply is now 10,000 times more powerful than it was 10 years ago,” Barnes said. “And street drugs of all types are being cut with carfentanyl: ecstasy, molly, lean, even street-sourced marijuana. All of those are potentially lethal when they are cut with even the tiniest amount of carfentanyl.”
One in three opioid deaths in construction in ‘20
Opioid use and abuse is startlingly common among workers in the construction sector. A recent report prepared by the Ontario Drug Policy Research Network suggests that construction workers made up nearly one in three deaths from opioids among employed Ontarians in 2020. It’s a trend that the Ontario Construction Consortium (OCC) has labelled “The Other Pandemic.”
“This situation is alarming,” says OCC Executive Director Phil Gillies. “Construction workers are dying from drug overdoses, a crisis largely driven by the widespread street distribution of the highly-addictive opioid fentanyl. And the 60-percent increase in deaths in 2020 has to be linked to the shutdowns and isolation imposed by the COVID pandemic. The increase in addiction and mental health issues that has accompanied the pandemic is impacting the construction workforce in a dramatic and tragic fashion."
“Construction is primed with risk factors for opioid use and abuse,” Barnes said. “Injuries happen and are usually managed through opioids, so they’re present and available. Construction work doesn’t always allow for days off, so if you need to get paid, you go to work, and you manage through the pain by taking pills. And it’s a hard-nosed, macho industry that’s heavily populated by men aged 20 to 49, who are by far the leading demographic among deaths from opioids.”
Patients, however, are just one group that is at risk of opioid overdoses. Barnes quoted data from one survey that showed that more than 70 percent of respondents to a survey on opioid use reported getting—either by buying or stealing—opioids from a family member or friend. Accidental ingestions are also common among children.
What makes opioids so dangerous is the speed with which they work. Since they are designed to put patients for sleep for surgery, they depress breathing. Overdose patients are therefore quickly at risk of brain damage from a lack of oxygen in their circulatory systems.
“Death can occur in an opioid overdose case in as little as three to five minutes,” said Barnes. “That’s not enough time for EMTs to arrive at a scene even if the overdose has been detected right away.”
The solution: naloxone nasal spray
Barnes wants every construction site to carry naloxone kits: simple nasal mist sprays that, in most cases, work in short order to restore breathing to someone who has overdosed on an opioid. The kits are free. They’re easy to use and—critically—they are effective only on people who are overdosing on opioids.
Getting naloxone into the body of someone who has overdosed on an opioid can make the difference between life and death, but it’s not a complete solution. If the overdose patient isn’t seen and treated by paramedics within 30 minutes, they can relapse into overdose.
“Naloxone will have no effect—zero—on someone who has not taken an opioid. It’s completely safe to use,” he said. “And remember that the Good Samaritan Drug Overdose Act provides some legal protection for individuals who seek emergency help during an overdose.”
Barnes concluded his presentation with a video of how to administer a naloxone kit, and invited participants to contact him by email at mbarnes@respectrx.ca to request free naloxone kits for their work sites.
A recording of Barnes’ presentation is available on the Link2Build website.