The issue: Construction work sites, by their nature, are generally hectic and less staffed due to work-saving technology and the raw reality of today’s economy, which favors lean staffing.
When all employees working at a construction site are at the top of their game, it is poetry in motion….a beautiful and impressive scene to behold. If 17.4 percent of construction workers are impaired by drug use (a statistic from the 2010–2011 national survey data, Substance Abuse and Mental Health Services Administration, SAMHSA), the work site choreography can turn dangerous.
The behavior of the stumbling, slurry drunk or the slow-mo, unfocussed marijuana stoner are easy to spot. What’s more challenging to catch is impairment from abuse of prescription pain medicine and heroin.
Many will recoil at the association of a doctor-prescribed drug, like oxycontin, and an illegal street drug like heroin, but here’s the 4-1-1, they are both opiods and are like kissing cousins. (Think of your home being ravaged by a nest of squirrels. To the hired exterminator, squirrels are no different than rats — same destruction and same methods to get rid of them — it’s just that squirrels are basically rats with good PR.)
Here’s the sad reality, the drug prescribed to a construction worker to relieve back pain or pain from an injury, for example, can be highly addictive. When the physician refuses to refill the prescription after a couple of times, the worker still wants the pills — the new addiction needs to be fed. So, instead of going to the pharmacy, they must go to a friend of a friend and illegally purchase the pills that were once legally prescribed to them. In time it becomes clear that acquiring illegal prescription drugs is far more expensive than heroin, which produces the same results.
According to the SAMHSA research, the construction trades rank the highest of all professions for heroin use, with 3.25 standard deviations from the average rate of heroin abuse/dependence. The industry far outstrips the second highest ranked entertainers, performers, and professional sports industry segment for heroin use/addiction.
The challenge with the opiate-impaired is that they may be cycling through two distinct stages while at work: either they are under the influence or they are in withdrawal.
While impaired, the employee may seem fine, but looking closer can reveal problems with concentration, effort, energy levels, mood swings, and just a general lethargy. Those at high levels of opiate use may show signs of narcosis, or “being on the nod,” as they fade into a state where they look “asleep on their feet.” These are the employees who doze out in the bathroom stall or oversleep in their cars on their breaks or lunches, as the central nervous system depressant they have over-consumed takes its toll. When you look at them their pupils are like pin dots, their eyelids are at half-mast, their pulse rates are quite low, and they are not fully functioning.
To be clear, an employee who is under a doctor’s care taking a medicinal dose of a prescribed opiate tablet and is following the prescription bottle directions is not the problem. That person can usually function just fine. The one who overmedicates with opiates or uses heroin is the problem.
At the other stage of addiction is the worker who is in some state of opiate withdrawal. This is a completely different person: irritable, edgy, restless, anxious, sweating, shaky, achy, clammy, fighting nausea, diarrhea, an upset stomach, watery eyes, or a non-stop runny nose. What might be taken for a seasonal allergy, bad cold, or touch of flu could actually be an opiate user having a bad day.
Probably the worst situation is being fully-addicted to injected heroin. An individual might have to inject the drug every four to six hours, every day, to avoid incredibly-uncomfortable withdrawal symptoms. The “going on-coming off” cycle is brutal business. As one longtime heroin user puts it, “It’s hard to divorce The Horse.”
In a perfect world, a prescription pain med or heroin addict in a construction crew would speak up and say, “I’m in trouble and I need help,” before the positive random urine test, before the incident or accident, and before the paramedics have to respond and give the employee a lifesaving dose of Narcan (Naloxone) to counteract the heart and lung-stopping consequences of the last fix.
Employers tend to be more supportive and helpful if you ask for help with an addiction, as opposed to getting caught selling drugs at work or stealing from the warehouse, petty cash fund, or their coworkers in order to fund their addiction.
Unfortunately, most opiate-addicted employees are too afraid, stubborn, or prideful to reach out for help and get treatment. Combined with their sense of denial, distorted thinking, minimizing, rationalizing, and blaming behavior it can lead them to discipline, termination, or death.
Supervisors and co-workers need to confront an opiate-impaired fellow employee, or tell an owner, manager, or HR about the suspicions. Considering the very real danger an impaired person is to themselves and the risks they expose others to through their behavior, calling them out is not about being a snitch; it’s about saving lives.
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