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Drug and alcohol treatment can bring workers back to the job

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There is no hard data, but anecdotal evidence suggests drug and alcoholic dependence is a growing problem in the B.C. construction industry, but there is help for those afflicted.

There is no hard data, but anecdotal evidence suggests drug and alcoholic dependence is a growing problem in the B.C. construction industry, but there is help for those afflicted.

“I expect the problem will get worse, too, as marijuana use becomes more socially acceptable,” said Mike McKenna, executive director of the B.C. Construction Safety Alliance.

To catch impaired workers on the worksite, the Construction Labour Relations Association (CLRA) of B.C. and the Bargaining Council of B.C. Building Trades Unions have developed the Construction Industry of B.C. Substance Abuse Testing and Treatment Programs Policy.

Dave Earle, CLRA’s director of HR services and government relations, said workers can be tested for impairment in a number of situations.

“They can be tested before access to the work site, with an oral fluid sample taken by a swab and analyzed in a lab,” Earle said.

“They can also be tested if the worker’s supervisor suspects impairment. A third case is post-incident testing, when someone is directly involved in an incident and his or her mental state may have contributed to the incident.”

Earle said voluntary drug-testing is also available.

“If a worker wants to be eligible to be dispatched to a worksite immediately, then he or she can take a swab test,” he said.

“If they pass, they’re free to go, but they’re subject to random testing on-site.”

If testing identifies an impairment, the worker is sent to a substance abuse specialist to determine if there’s a dependence problem and if treatment is required.

Treatment is available from a number of organizations, including HealthQuest, a Burnaby-based occupational health company.

“A typical program involves detoxification, for the physical symptoms, primary treatment, for the psychological aspects, and then after-care,” said Dr. Ray Baker, associate clinical professor at the University of British Columbia Faculty of Medicine and a partner in HealthQuest.

Baker said most treatment and post-treatment programs are based on a psychological motivational technique called contingency management, more colloquially known as the carrot-and-stick approach.

“The key to successful treatment is that the participant needs to want something, which in this case means keeping his or her job,” he said.

The idea is to get addicts to change their calculation of the costs and benefits of their addiction.

“They will continue to use as long as the benefits outweigh the costs,” he said.

“The mood-altering drug reward for them is worth the cost. Things that stimulate the reward circuits of the brain cause changes and those changes are irreversible.”

Post-treatment programs typically require participants to commit to a relapse prevention program.

These programs include group support, counseling sessions and monitoring.

“A good monitoring program can pick up a relapse before it occurs, by detecting behavioral and psychological changes,” Baker said.

“If a monitor detects a change of mood from enthusiasm to reluctance, then a possible relapse can be prevented.”

The key element of monitoring is participant accountability, said Janice Johnson, managing director of Alliance Medical Monitoring Inc. in Burnaby.

Alliance’s monitoring programs can also include random urine tests.

“Participants can come into Alliance’s offices or go to a lab anywhere in Canada,” she said.

Unlike the swab test, which detects impairment that can jeopardize workplace safety, the urine test detects use, which is a sign of relapse.

In addition to professionals such as Baker and Johnson, the construction industry offers assistance in the form of the Construction Industry Drug and Alcohol Rehabilitation Plan.

“The plan is a joint union-management program that offers help to workers and their families who have drug or alcohol dependence problems,” said Mike Burgess, director of arbitration special services of the CLRA.

The plan is provided by the CLRA and the B.C. and Yukon Territory Building and Construction Trades Council.

The plan operates an in-house rehab program at an eight-bed treatment centre in New Westminster.

The program consists of five weeks of group therapy, one-on-one counseling, lectures and life-skills training.

“The participants come to the centre after having detoxed elsewhere,” Burgess said. “While they are in the program, they are subject to random urine testing. If they test positive, they have to leave.”

More than 6,000 people have received some sort of assistance since the plan was founded in the 1980s as a referral service.

More than 1,700 people have passed through the treatment centre since it was established in 1989.

“The treatment centre is for men only,” Burgess said.

“Female and youth get referred to other treatment programs. Our overall rate of success is high.”

by Peter Caulfield

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