By March 6, 2019, Trevor Botkin’s drug addiction had made his life such a mess that the career construction superintendent was planning to end it.
“I was waiting for my mom to get up and go to work so I [could] park my Jeep in her garage,” Botkin said. “And that was going to be the end of my story.”
The stress of work and his perfectionist nature — he said “yes to everything” but lived in a constant fear of failure — had also taken a toll.
“The drugs were starting to become the only place I could find any calm and peace in my life,” he said. His drugs were cocaine, ketamine, and benzodiazepines, which he never used with the other two. “I used the benzos pretty much to put myself back together,” he said.
Early that fateful morning, though, his death wish had diminished. Botkin realized he didn’t want his mother to find him dead. So he summoned the courage to ask her for help.
And then a pair of miracles happened.
His mother covered the cost of 60 days of treatment at a private addictions recovery centre on Vancouver Island and he was able to get into the program immediately.
“The stars aligned and I just happened to find myself in a safe space,” Botkin said.
“And then the hard work began,” he said.
Overdoses among trades ‘smaller proportion’ than portrayed
In 2018, the BC Coroners Service issued a report that said 55 per cent of employed people who died of illicit drug overdoses between 2016 and 2017 worked in the trades and transport industries.
The BC Coroners Service 2022 death review panel estimated that those working in the industrial classification of trades, transport and equipment operators accounted for 52 per cent of the 35 per cent of people employed at the time of fatal illicit drug overdose. That works out to about 18 per cent, or just under one in five deaths, a figure that has been widely reported.
Despite this, last September, Vicky Waldron, executive director of the Construction Industry Rehabilitation Plan, told the Health legislative committee “approximately 55 percent of those who have overdosed have worked in the construction sector.”
One month later, the BC Building Trades repeated the error in a news release still posted on its website.
That figure is certainly wrong — although how wrong is open to interpretation.
A 2022 study in Ontario calculated one in 13 (7.7 per cent) of the employed people who died of toxic drug overdose in the province from July 2017 to December 2020 worked in construction and related trades.
Addictions researchers at Simon Fraser University argue that the dramatic difference in death rates between the B.C. and Ontario reports lies with a misinterpretation of definition of “employed.”
Using Statistics Canada definitions, the SFU study calculates about seven per cent of the “first-recorded poisonings” in B.C. were of people earning more than $500 in construction-related annual income.
“The findings … emphasize that poisonings overwhelmingly involve people who are unemployed, use multiple drugs, and struggle with mental illness,” noted the report from SFU’s Centre for Applied Research in Mental Health and Addictions.
“The narrative of substantial overlap between poisonings and construction appears to be a disservice to the vast majority of those who are at risk of poisoning and diverts attention from more robustly demonstrated safety and health-related risks in the construction sector,” the SFU report said.
Unemployment linked to fatal poisonings
There is now abundant evidence that unemployment is powerfully related to fatal poisonings among young men, said addictions researcher Dr. Julian Somers, a co-author of the SFU report.
Illicit drug-related deaths in the construction sector “account for a smaller proportion than has been portrayed” and more data needs to be collected to better understand where the problems are in order to prioritize how to address them, Somers said.
Which is not to say addiction is not a problem in the construction industry.
The SFU study asked people about their substance use in the past 12 months. Eighty-two per cent reported using alcohol; 42 per cent, cannabis; 16 per cent, mushrooms or LSD; nine per cent, cocaine; 10 per cent, opioid medications, and less than one per cent reported using fentanyl or heroin. Only five per cent said they’d used illicit drugs before or at work, with 13 per cent indicating they’d used cannabis.
Study data was drawn from online surveys completed by 639 people and interviews of “key informants” from 35 organizations, including IUOE local 115, CIRP, WorkSafeBC, and VICA.
The top illicit drugs involved in overdose deaths in BC in 2022 were fentanyl and its analogues, cocaine, methamphetamine, and other opioids, with fentanyl detected in 82 per cent of deaths and a majority of deaths involving multiple drugs, according to a January 2023 report from the BC Coroners Service.
Construction culture ‘a culprit’
Six years ago, when Botkin was still a construction superintendent, he had to fire a young man for drug use.
“I had to say, ‘Matt, you’re unsafe to be here, and I’ve got to let you go,’” Botkin said. “‘But as soon as you’re in better condition, you’re in a better place, you come and see me first, and I’ll put you back on the site.’”
Within about a month, though, Matt was dead.
“They don’t know if it was suicide or accidental overdose,” Botkin recalled. “It was fentanyl, for sure.”
The culture of construction work was also a culprit. The work is often dirty and physically taxing, leading to fatigue and muscle pain.
“It’s one of those jobs where we physically accept people in a lesser condition than we would in an office setting,” said Botkin, who is now general manager of HeroWork Victoria, a non-profit that does “radical” building renovations for charities. “What if the culture on the job site was that we look out for one another, and we support one another better?”
“I’d be lying to you if I said I haven’t seen members in the prime of their careers die of overdoses,” said Josh Towsley, assistant business manager of local 115 of the International Union of Operating Engineers, which has about 13,000 of the union’s 15,000 members in B.C.
Towsley said his union, and construction unions generally, are committed to supporting their members struggling with addiction, relying on initiatives like the Construction Industry Rehabilitation Plan.
“(CIRP) is absolutely life-changing for members in the construction industry and I can’t speak highly enough of the work they do,” Towsley said. “They get people assessed. They get them the treatment. And they’re thorough.”
Another initiative that is starting to change workplace culture is Tailgate Toolkit, a joint endeavour of the Vancouver Island Construction Association and Island Health.
Tailgate Toolkit is a play on the toolbox talk, a safety meeting that kicks off the workday on a job site, said Rory Kulmala, chief executive officer of the Vancouver Island Construction Association.
“It’s embedded into the fabric of construction,” Kulmala said. “Because it’s mandatory, it removes any sensitivities that somebody might go to something and be outed. Everybody is there.”
What began as a pilot project in 2021 is now open to any construction company.
“We take about 35 to 45 minutes to talk about what are addictions,” Kulmala said. “What are the risks to using alone? We talk about safe use. So we’re not in a position to judge anybody. We say, ‘Look, if you’re going to do it, here are some resources.’”
At latest count, project supervisors had presented 140 tailgate talks to more than 3,000 workers, Kulmala said.
VICA has changed its focus from “opioid crisis to toxic drug supply,” Kulmala said, “because that’s really the underlying crisis right now.” He added that VICA is careful to avoid positioning the crisis as a construction issue. “Our demographic is clearly probably the most relevant contributor to why the stats are affecting our sector.”
From heroin and homelessness to ‘Skidrow CEO’
In the late 1980s Joe Roberts was in that demographic of young men between 20 and 60. He performed lower-skilled construction work in Vancouver, such as acid-washing buildings for bricklayers. He was the kind of occasional labourer with minimal formal education that SFU’s Somers describes as most likely to succumb to addiction.
“I wouldn’t say I was a trades person,” Robert said. “I was someone who, if I showed up at a job site, they’d give me a wheelbarrow and a hardhat.”
It was during those years that he got into hard drugs like heroin, which led him into occasional bouts of homelessness on Vancouver’s Downtown East Side.
He has long since turned his life around and now makes his living largely as a motivational speaker, who calls himself the Skidrow CEO.
“It was having access to the resources and having people in my corner that were there for me,” Roberts recalled. Originally from Ontario, he reconnected with his mom, returned home and entered detox and residential treatment. “And after six months of treatment, I went back to school.”
‘I was scared’
Another motivator was terror. “People in my age group started to die,” he said. “I was scared.”
This May, Roberts will deliver a keynote address in Vancouver at the annual conference of the Crane Rental Association of Canada. He said he will recount his 9,000-kilometre walk across Canada, aiming to “touch, move, honour and inspire.”
“Just because someone has lived experience doesn’t mean they should be speaking as an expert on a topic,” Roberts said. But it has earned him some insight into possible solutions.
“It’s not just about safe supply or [decriminalization],” Roberts said. “There has to be an equally huge investment on access to resources and dissuasion. Look at Portugal’s model. Yes, they decrimmed. But when people use that as a justification, they conveniently leave out the fact that they invested hundreds of millions of dollars in access to resources, access to treatment, access to mental-health support, access to housing, access to all of the things that will be needed for that vulnerable population.”
Roberts was careful not to equate his experiences decades ago to what is happening today, “where you’ve got substances that are killing people in six minutes.”
His advice would be to follow peer-reviewed data and evidence to deal with the crisis. “Because if we don’t, then we’re just doing more of the same.”
Safer supply only part of solution
The big concerns these days is not just the extreme potency of the drugs, but also the risk of cross-contamination. Many drug users risk buying contaminated supply from the black market, then dying at home.
Drug checking across the province detected fentanyl in 89 per cent of opioid samples and three per cent of cocaine sampled, according to the BC Centre on Substance Use.
It’s this fear of drug contamination that leads some addictions researchers and construction industry leaders to promote safer supplies of illicit drugs.
The authors of the Ontario report on opioid use in the construction industry cited “the need to address structural barriers to appropriate pain management and injury prevention throughout the construction industry,” including rehabilitation after a workplace injury, treatment, and “education around the risks of polysubstance use.”
The Ontario researchers also advocated “harm reduction services,” such as naloxone distribution, supervised consumption services, and safer drug supplies.
Similarly, the SFU report findings support practices “associated with harm reduction as well as the promotion of wellness.” However, research authors also call for more attention on the latter, such as via therapeutic communities and other vocational programs.
“By contrast, prioritizing the distribution of opioid medications across Canada’s construction sites is incapable of assisting the vast majority of people dying of drug poisoning and who are unemployed,” the SFU report said.
“We didn’t get there overnight,” said Dave Earle, president and CEO of the BC Trucking Association. “It’s going to take us a while to get out of this.”
Earle is among those who see safer supply as part of the solution, but not the solution.
A former employer administrator for the substance abuse testing and treatment program with the Construction Labour Relations Association of BC, Earle said there’s a lack of understanding in both the construction and transport industries that “opiates are in everything,” including popular recreational drugs like cocaine.
The bigger issue for him and others is why so many Canadians are feeling so isolated and disconnected.
Most of those Earle worked with at the labour relations association “were working relatively steadily, if not completely full time,” he said. “Many of them were working in remote camps and making very good money.”
“When you look at somebody who’s an addict, the question not to ask is, ‘What’s wrong with you?’ The right question to ask is, ‘What happened to you?’” Earle said.
Building bridges between harm reduction and recovery
At Cedars at Cobble Hill, where Botkin jumpstarted his recovery four years ago, chief executive officer Stacey Petersen said addiction differs from other chronic disorders in its impact on the brain.
“The executive functioning is completely impaired when somebody’s under the influence,” Petersen said. “When your executive functioning is impaired, you’re not making great decisions. Addiction is a chronic brain disorder; it’s not a moral failing.”
Petersen also agreed with the oft-asserted message of drug-user advocates that it’s important to meet them where they are. “But don’t leave them there,” he said.
While Cedars, which can accommodate 74 clients with a staff of 90, does employ harm-reduction strategies such as opioid agonist therapies to guard against overdose and death — “that’s about the only thing I like about it” — the end goal is abstinence and recovery.
“Tell me what drugs are actually safe for you, period?” Petersen said. “What we need is more focus on a recovery-oriented system of care. And that means we build bridges between harm reduction and recovery.”
Therapeutic communities a ‘necessary building block’
In February, BC Opposition leader Kevin Falcon said if elected, his government would invest $1.5 billion over three years in mental health and addiction services that would include free treatment beds on demand with half the money going to “complex health supports” and “recovery communities” across the province. The governing NDP followed up two weeks later with a less ambitious $1 billion plan of their own.
Somers said the best place to spend that money would be on “therapeutic communities,” where young people go to live for at least two years and take “meaningful and very well-organized vocational training.”
B.C. currently has a few small therapeutic communities, such as the John Volken Academy in Surrey. But what Somers envisions are of a much larger scale, serving upwards of 100 people.
“Therapeutic communities were integral to Portugal’s success,” Somers said. “And they simply are a necessary building block in any kind of system. That would be one way that the construction sector could partner in a way that benefits society.”
Petersen said the province needs more services “across the continuum” of treatment and recovery. But he cautioned, “Capacity is going to be an issue. You have to engage the not-for-profit sector. You have to engage the for-profit sector. Because you’re not going to be building a ton of treatment centres overnight.”
Increasing that capacity must also utilize credible services that are licensed and accredited, Petersen said. Cedars itself has a comprehensive continuum of services that begin with detox, and also include treatment, housing, and continuing care, which lasts for a year after treatment. After all that, those individuals become part of an alumni association.
“The opposite of addiction is connection,” said Petersen, who has been in recovery himself for 35 years. “The more connections you can make after treatment for the individual, the better.”
“The drugs were really a medicine or just a symptom of a place where I was in my life,” said Botkin. “I had to do work around some of my upbringing and of my own self-identity, how I use work as a drug, how I worked myself into the ground.”
Problematic drug use can become a social issue beyond any one person’s control, he said. Confronting that requires empathy and understanding as well as treatment and guidance. But, he added, drugs are only part of many people’s suffering.
“If you took the drugs away, they’d still be unemployable,” Botkin said. “They’d still be a challenge for society. And we need to have supports in place for those people as well.