Opioid deaths in the U.S. and Canada are at epidemic levels, ravaging communities across regional, ethnic and socioeconomic divides. But no industry suffers higher rates of addiction and death than one of our own: construction.

"This is something that has hit our industry especially hard," said International President Lonnie R. Stephenson. "I want every one of our members to know that the IBEW is committed to doing everything we can to help any of our brothers and sisters who are suffering. No one is alone in this fight."

Every day across the U.S. more than 130 people die from opioid overdoses, according to the National Institute on Drug Abuse. The numbers are proportionally similar in Canada, where, like the U.S., the crisis is fueled by a combination of factors, including reckless doctors, profit-hungry pharmaceutical companies and more.

"There's an individualistic culture in Canada and the U.S. that says, 'I'll do my thing and you do yours.' We deal with things in private," said Jim Watson, an international representative in the Education Department who runs trainings on mental health and addiction. "For something like this, though, we need to start talking."

Since 1999, sales of prescription painkillers have skyrocketed 300%, according to the Midwest Economic Policy Institute. And since 2012, more than 259 million opioid prescriptions have been written — enough for every American adult to have their own bottle.

Of course, opioids can be safely taken and help a lot of people in pain. But too often, they're misused. And for anyone in construction, it's a near perfect recipe for addiction.

Few occupations are more physically demanding. The injury rate is 77% higher than the national average, according to MEPI, so it should come as no surprise that substance abuse is nearly twice as high as the national average.

On top of that, construction workers only get paid if they show up, so pain medication is as common on the job as hard hats and tape measures. Home rest or physical therapy doesn't pay the bills.

In Ohio, construction workers were seven times more likely to die of an overdose than other working people, according to a Cleveland Plain Dealer analysis. In British Columbia, 55% of the province's overdose deaths were construction and transportation workers, reported the Ottawa Citizen.

The Plain Dealer numbers from 2016 pin most deaths on heroin or fentanyl (a synthetic opioid more deadly than heroin), but many of those who died started with prescription painkillers deceptively marketed as safe.

"They knew all along it was addictive," Boston Local 103 member Brian Galvin said of the pharmaceutical industry. "It's a broken system."

Galvin, 43, suffered with addiction from a young age. He's been sober since 2006 and now advocates for others who are going through a similar battle.

"We need to break the stigma of what drug addiction and alcoholism are," Galvin said. "People with this disease aren't bad people getting good, they're sick people getting healthy."

A Massachusetts Department of Public Health study found that workers in the building trades and mining accounted for almost a quarter of all opioid overdose deaths in the Bay State. The report also noted higher injury rates in construction than in other professions, with back pain the most common chronic ailment.

That's how it started for Local 103 member Bryan Snow. The opioid painkillers he was given came with the typical warnings, but nothing to suggest the level of addiction he'd experience.

"Addiction takes you to a very deep, dark place," Snow said. "It's like you're taking the drug to feel normal, but then it wears off, so you never feel good. It's like there's no way out."

Fortunately, people noticed, including some at Local 103, and they got him the help he needed.

"If my union didn't help, I wouldn't be where I am now," said Snow, who comes from a family of electricians. "I needed to be an active participant too, but I also needed help to realize where I was at."

Local 103 recently hosted a weeklong conference put on by Boston-area building trades on substance abuse disorders and the stigma surrounding them.

The event's organizers called for naloxone to be available at all job sites. Sometimes referred to by the brand names Narcan and Evzio, naloxone is a potentially life-saving drug that reverses the effects of an opioid overdose. Snow says he carries it with him all the time. It's part of his decision to be open about his addiction and recovery, to let others know they're not alone.

"I'm here to say it's OK, that there's a way out," Snow said.

Breaking the Stigma

But the way out is often blocked.

There are structural issues that push people into addiction, like a lack of paid time off or a culture of working through the pain, but the stigma associated with an addict can be just as damaging. "Just because someone's addicted, it doesn't make them a bad person," Snow said. "If someone was walking around with cancer, we wouldn't judge them or shun them. We need to treat addiction like that."

Once certain painkillers take hold, the stigma of addiction surrounding not just substance abuse, but mental health in general, often makes recovery even harder.

"We have these things that we hold in secret and keep quiet about, and it's hurting us," Watson said. "We need to educate ourselves and our leaders on how to deal with this."

Watson noted that suicide rates are higher for those with addiction issues and a report from the Centers for Disease Control found that those in construction and extraction have the highest rates of male suicide. Opioid use is associated with a 75% increase in the likelihood of a suicide attempt, according to the Addiction Center.

"There's no way to talk about addiction without talking about suicide too," Watson said. "We have to talk about all of these issues."

Talking about sensitive issues like addiction, depression, suicide and other mental health issues isn't something that comes easy to most, especially men, Watson said. And construction is overwhelmingly a male profession. Furthermore, according to the American Foundation for Suicide Prevention, men die by suicide at a rate three times higher than that of women.

"It's a testosterone-driven culture. Men don't talk about emotions or pain," Watson said. "There's this belief that, 'if I'm emotional, then I'm not a man.'"

Watson, who sits on the Canadian Labour Congress' Labour Education Advisory Committee, says he spends a lot of time at his trainings creating a space where members feel safe enough to talk openly about their situation. The trainings have received good reviews, he said.

Stephenson has appointed Construction and Maintenance Department Director Mike Richard to serve on North America's Building Trades Union's opioid task force. Currently the task force is gathering data and best practices from the U.S. and Canada and is working on an actionable plan that it can recommend to the NABTU general presidents, Richard said.

''We have members dying and suffering through addiction, and we have a moral obligation to do all that we can," Richard said.

The task force has also developed vetting guidelines for treatment centers.

"Not all treatment centers are the same or even effective," Richard said. "A lot are just in it for the money, and the treatment of our members is too important to leave to chance."

In June, Stephenson participated in a panel hosted by the Kennedy Forum, an organization that works on mental health care issues. The panel was part of a daylong event and focused on combating mental health stigma in the workplace.

"Addiction can creep up on anyone, and every IBEW member needs to know that substance abuse is first and foremost a health issue that must be dealt with," Stephenson said. "And dealing with mental health is part of that."

MEPI's report on the opioid epidemic in construction focused on the Midwest, which suffers from some of the highest rates of misuse and death. Its recommendations for addressing the issue, however, can be applied across the U.S. and Canada.

Among them are providing health insurance that covers substance abuse and mental health treatment, encouraging alternatives to opioids like physical therapy and anti-inflammatory medications for certain injuries, providing at least two weeks of paid sick leave and updating policies to include regular drug testing but not immediately firing those who test positive.

Watson says most locals have employee assistance plans that offer assistance to those with substance use issues. However, many only cover about six visits. And depending on the availability, a member might have to take off work to attend.

"We think it's been one-size-fits-all and we need to individualize it, to look at it from a multifaceted point of view," Watson said. "Thirty days might be enough for some, but not for everyone."

'It Takes a Tribe'

Syracuse, N.Y., Local 43; Philadelphia Local 98; Providence, R.I., Local 99 and Vancouver, British Columbia, Local 213 all offer naloxone training to their membership and in some cases for family members too. Local 213 offers it along with a session on mental health. Local 99 includes it with CPR and awareness training on the symptoms to look for in someone who might need help.

For Local 43, the training was part of a comprehensive program they developed with an area hospital. Business Manager Al Marzullo said they've put about 150 apprentices through it so far as well as held a training for the general membership and their family members, which was well attended.

"I didn't know how the training would be accepted, but our apprentices and members were ecstatic about it," Marzullo said. "Their eyes never left the screen during the presentation."

For Marzullo and the local, it's personal. They had a second-year apprentice die last year.

"This job is hard enough, but the hardest thing is to see a 26-year-old apprentice in a casket and look his parents in their eyes and give my condolences," Marzullo said. "At that point, I knew we had to do something. We had to get out in front of it."

Local 99 provides rehabilitation services and an anonymous support group, says Alvin Reyes, the Reach Out and Engage the Next Generation of Electrical Workers representative. RENEW, along with NextGen in Canada, is the IBEW initiative to get more young members involved in the union. Those services are provided with support from RENEW, reflecting the joint commitment between the local and the chapter, Reyes said.

"This crisis has impacted us all," said Reyes, who is also Local 99's membership development coordinator. "We let our brothers and sisters know that we're a family and we do not abandon them, especially in a time of crisis."

RENEW/NextGen has an important role to play, said Tarn Goelling, director of Civic and Community Engagement. According to MEPI, 66% of those who misuse pain medication are between the ages of 18 and 34 years old.

"This is an opportunity for RENEW," Goelling said. "Its role is to address issues that affect young members, and with the right education and tools, chapters could really be the bridge between their members and the locals."

In the Tenth District, International Vice President Brent Hall wanted to get in front of the issue and held a session on opioids at last year's annual progress meeting for leaders in Arkansas, North Carolina, South Carolina and Tennessee.

"The opioid crisis in our four states is at epidemic levels, and we would be naïve to believe we do not have members that have or could get trapped in this dilemma," Hall said.

Other districts have taken similar steps or are planning to engage members and leaders on the issue at upcoming meetings.

At an international level, the IBEW has supported and will continue to seek common-sense legislative actions in both the U.S. and Canada to expand treatment options and seek solutions to the crisis. More research into alternative pain-management and non-addictive medications is needed, and lawmakers in both countries need to do more to take what is, in effect, legal heroin off the market.

But both Galvin and Snow stressed the importance of looking out for one another and knowing what to look for in a brother or sister who is suffering. Both say they're glad to be able to play their roles as someone in recovery who can help others, including their IBEW brothers and sisters.

"Someone did it for me," Snow said. "Part of staying clean and sober is giving back."

Knowing that you have a support system there for you is incredibly important, Galvin said.

"It takes a tribe," Galvin said. "If there weren't people there to help me, I would without a doubt be dead."

What is your local doing to combat opioid and other substance abuse issues? Let us know and we may highlight it in a future Electrical Worker story. Email us at media@ibew.org.