In the last few months, I have been posting articles about addiction that have come straight from the news. I am deeply worried about some of the things we’ve been hearing about, and most of them have had a harm-reduction slant, rather than a full-recovery perspective.
There are many approaches to addiction counselling and recovery – many different viewpoints about what might create the best results. I’m going to share mine here. My perspective is one that comes from lived experience. As an Addictions Therapist working for the past three decades primarily with families that have been devastated by a loved one’s addiction, I have worked both on the streets of the Downtown Eastside area of Vancouver as well as in private practice. I am also a recovering addict myself with over 35 years clean and sober, after suffering from an excruciating 15-year opioid addiction. I am very aware that continued harm reduction is like that proverbial band-aid on a heart attack. It only helps for a very short time and only in very small ways. If we’re looking for a way to stop the overdose crisis that has gone on for far too many years – and which, not surprisingly, only keeps getting worse – then harm reduction is not the sustainable option that too many people still hope it will be.
The Inherent Problems of Harm Reduction
From my perspective, what we have seen in recent months has not helped the opioid crisis. We have witnessed governments legalize drugs in the guise of destigmatizing addiction. We have watched in disbelief as prescriptions for opioids began to be handed out from machines located on accessible street corners of our cities. Every day I hear the terrified reactions of the families of addicts, as they see more and more of these ‘harm-reduction’ approaches being put into action. These families are doing their best to help the addicts they love stop using, while these attempts only serve to enable their loved ones to continue putting themselves at risk. We have been shaking our collective head as addicts obtain legally prescribed scripts from their doctors, push a button to have their meds dispensed out of these machines, and then turn around and sell them for a profit to teens who bring them back to sell to others in their suburban communities. The children of parents in these areas may not be using drugs – yet – but some of them are now illegally dealing them.
And we have heard, ironically from an addict in recovery, that we should now be paying practicing addicts $20/day to go to rehab. But if we give addicts the money they need to sustain their addiction, under the pretext of harm reduction, it won’t take long for this approach to backfire. I know I’m not the only one who is concerned about this tactic. There are many of us who do not see this as a viable option – for so many reasons.
I have written about the inherent problems of harm reduction on a number of occasions, and I’m relieved to know that there are more and more people who now agree with me. That wasn’t always the case: for many years I was a lone voice in the wilderness talking about how we needed to reassess what we knew, thought, and believed about addiction – so that we could make even a dent in the horrific numbers of people dying from opioids and other toxic drugs.
Recently, there was yet another news story that chilled me to my core because the many ramifications are so potentially dangerous and traumatizing. This story has to do with the construction sector – specifically a carpenter’s union – which has made the decision to train their workers to administer naloxone (aka Narcan) to their peers and colleagues who end up overdosing at work – basically dying right in front of their eyes.
I am all for saving lives, especially the lives of addicts who have overdosed. As the magnificent saying goes, there but for the grace of God go I – that could have been me, if I had made a different choice about facing the fact that I was heavily addicted to opioids. I want Narcan to be available and I’m glad that it is. It could save someone’s life. But I want it to be used with wisdom and proper training – which essentially means setting and maintaining healthy boundaries, with respectful consequences that mean something to the addicts who are choosing – yes, choosing – to continue to sabotage their lives by ingesting substances they already know could be toxic, dangerous, and life-changing.
So, it’s not the availability of naloxone that is problematic for me. Rather, it is the way it’s going to be administered – and how often – that I have a deep, strong issue with.
Let’s Take a Closer Look at Naloxone
I believe we need to take a much closer look at what is being planned around this.
Preparation and training will be very important in these situations. When we administer naloxone to someone who is unconscious – or worse – it is now well known that the recipient could easily physically punch, kick, spit or vomit on those who are trying to resuscitate them. It has actually been suggested that people administering Narcan should be dressed in PPE – Personal Protective Equipment – and for good reason. But the problem is that PPE can only protect us physically. How do we take care of ourselves emotionally, mentally, and spiritually when faced with something like this? The trauma that can be experienced when we see someone we know, someone we’ve been working with, overdose to the point of needing naloxone to revive them is an undeniably real issue that can leave lasting scars on everybody involved. Certainly, we can’t expect people to just go back to work as if nothing happened, can we? For onlookers and responders alike, skilled trauma counselling should be readily available – if not mandated.
It is vital to remember that our construction industry is a profoundly important one for all of us. These are the very talented people who build the structures we all live, work, and play in. There is no question that construction workers – including carpenters – need to be clean and sober so that they don’t make mistakes that could lead to buildings crashing to the ground, even years from the time they were built. Am I being too dramatic? I don’t think so. How many of us would want to occupy a poorly constructed building where miscalculations were made because someone had either been high or hungover on the job? And this needs to change before something catastrophic happens – not after.
The Questions We Need to be Asking Ourselves
Safety professionals, HR professionals, and leaders have a tough job – they often have to navigate very sensitive situations with their employees. As a result, we need to be supporting leaders, HR, and safety officers to be able to have the tools and the training they need to create healthy environments where workers are clean and sober, and people feel safe to bring their concerns forward.
Addicts are very good at hiding what they’re doing, and in the construction industry workers can sometimes go without seeing their leaders and supervisors for days or even longer. Issues of impairment can go unnoticed due to isolative working conditions. Are we supporting our safety professionals and HR professionals enough in the difficult job of making sure the workplace is hazard-free – a safe place where people are not showing up impaired? Are we providing them with education, training and the tools they need to be able to do this job effectively? Are our workplaces prepared for crises, and do they have an inviting culture for workers to safely bring forward concerns about a colleague, without fear of retribution?
I truly believe that addiction can be stopped, and this is why I am so passionate about these issues. One of our most important goals in 2023-2024 at Love With Boundaries is to provide support and education to construction industries, to leaders and safety professionals like Human Resources – to help them deal with these tough situations, where they don’t always have the training and support they need.
I can only imagine what it must be like for Human Resource professionals, leaders and safety officials dealing with addiction in the workplace, to then have to create and enforce boundaries and appropriate responses when this does occur. I can only imagine how stressful that must be for them. If this issue of rampant addiction in the workplace is not being discussed in the ways that it needs to be – especially with the ones who are addicted – the situation will only get worse over time.
Addiction is progressive – it doesn’t get better without the appropriate help. The very people who need to be challenged about making the entire place unsafe, are the very people for whom there appear to be few – if any – boundaries or appropriate consequences. As a result, the only thing that happens is that they may be able to be brought back to life via naloxone, as many times as necessary.
And if nothing changes, nothing changes.
We need to support our leaders and safety professionals to know how to address this problematic issue that has grown more and more out of control over the past several years.
In Part 2, I will discuss how to HELP instead of ENABLE, and offer an alternative plan.