This has been a long, arduous year for all Canadians. The SARS-CoV-2 pandemic has impacted all of us in one way or another, whether through the loss of someone close to us, shuttering of one’s business, loss of employment/working more hours than usual, financial stress, or isolation, to name a few. The impacts, however, on those individuals who use substances have been unimaginable. We are facing a growing epidemic within our current pandemic, in the form of an opioid crisis. We have also seen a rise in the use of alcohol, cannabis and, other substances over the last year.
Canadians with a substance use disorder, or even those without an official diagnosis who may use substances recreationally, have seen the loss of support structures with a movement to on-line resources of which, not all individuals have the ability to access. Increasing rates of anxiety, depression, and Post-Traumatic Stress Disorder (PTSD) can also play a role in increasing the use of substances. Although helpful for reducing transmission of SARS-CoV-2, stay-at-home orders lead to isolation, loss of social supports and social connections, loss of access to much-needed treatment, and a strain on individuals’ mental well-being. Those with a strong support system and the tools necessary to combat these challenging times may be faring well. However, for many, living through a pandemic has taken a tremendous toll on their mental health.
The opioid epidemic has been a growing tragedy where we have seen the highest death rates due to opioid poisoning in 2020. This is partially due to the above factors, as well as increasing contamination of opioids and increase in potency of the contaminants (carfentanil for example). People who use opioids do work. It is estimated that approximately 65 – 69 % of individuals who use substances work, and 74% of those who binge alcohol or have an alcohol use disorder work. The current epidemic very much impacts the workplace.
Alcohol and cannabis use has increased throughout the last year in those who use these legal substances. Nanos and Canadian Centre for Substance Use and Addiction conducted surveys near the beginning of the pandemic showing that 6% of those staying home due to the pandemic have increased their use of cannabis, while that number was 18% when asked about alcohol. The Canadian Cannabis Survey 2020 found that 19% of individuals have increased their use of cannabis due to factors related to COVID-19. The respondents cited the following reasons for their increase in cannabis use: to relax (73%), boredom (65%), stress (53%), and anxiety (53%). In line with these findings, DriverCheck has found an increase in lab-based drug positivity rate in tests conducted in 2020 compared to 2019.
Employers should be aware of the factors contributing to increased legal and illicit substance use during this pandemic. The fallout of COVID-19 may likely outlast the pandemic itself. PTSD, anxiety, and depression are a growing concern, and from this, substance use can emerge and increase. Being mindful of the tremendous stress that this pandemic has had on most Canadians, employers should continue to use the strategies and support systems they already have in place for their employees with substance use disorder.
Reminding employees of the resources through work and in the community is helpful. In times such as these, employees may not know where to turn for help, especially for those who have never required supports such as these. Understanding the role of mental health on substance use, educating employees about the trends of increased use of alcohol, cannabis, and illicit substance this last year, and providing resources for those who need help are some of the ways that employers can make a positive difference in the lives of those who use substances. While substance use has a significant impact on safety for those who perform safety-sensitive duties and work in safety-sensitive environments, understanding and openly discussing the underlying reasons for substance use can help to allow those who need help to get it.
While we begin to emerge from this tsunami over the next number of months to a year, being aware of the growing impact of the pandemic on both mental health and substance use is vital for all employers. The real fall-out of SARS-CoV-2 will become more and more evident over time. With open discussions and supports, employees and Canadians may be able to get the help they need to move along the continuum of healing.
Below is a list of valuable resources that can be shared with your family, friends, and co-workers.
DR. MELISSA SNIDER-ADLER, M.D., C.C.F.P.(AM), M.R.O. (AAMRO), D,A.B.A.M.
CHIEF MEDICAL REVIEW OFFICER, DRIVERCHECK INC.
PHYSICIAN, ADDICTION MEDICINE
Dr. Snider-Adler is the Chief Medical Review Officer for DriverCheck. Her background is in Family Medicine, but now works primarily in the field of Addiction Medicine. Dr. Snider-Adler is certified as a Medical Review Officer by the American Association of Medical Review Officers.
As part of DriverCheck’s medical team, during the pandemic, Dr. Snider-Adler has authored and contributed to guidance documents advising organizations and employers on organizational risks during COVID-19. She has led webinars to educate clients on testing options for COVID-19, clarified what testing can and cannot tell you, and provided advice on point-of-care testing devices and their test characteristics and accuracy.
Dr. Snider-Adler is an Assistant Professor at Queen's University Department of Family Medicine. She has an Added Competency in Addiction Medicine from the College of Family Physicians and is certified by the American Board of Addiction Medicine. She is also a Fellow of the American Society of Addiction Medicine. Dr. Snider-Adler gives talks across Canada and the U.S. to companies, physicians, and the community about workplace substance use, drug, and alcohol testing, and COVID-19 testing and management in the workplace.
 Hersch, R., & Cook, R. F. (2012). Interventions and policies in the workplace (United Nations Office on Drug Use and Crime Technical Consultation on International Standards on Drug use Prevention).