For families, the tragedy of opioids is beyond measure. For Canada, the cost is tens of billions in lost productivity, a Globe analysis finds – by Jason Kirby @ The Globe and Mail – Read the source article
On the evening of Aug. 5, Michael Fairchild left his brother’s home in northeast Ottawa and made his way to a street near one of the Byward Market’s homeless shelters. There, he bought and smoked crack that it’s believed was laced with fentanyl.
When someone found him shortly after, his face was blue. Twice before in recent months, Mr. Fairchild had similarly fallen unconscious after a suspected fentanyl overdose. This time, efforts to revive him failed.
And so, at around 9:30 p.m., Mr. Fairchild became one of 10 men and women to die from a suspected overdose in Ottawa that month, one of an estimated 18 opioid toxicity deaths that day across Canada, and one more addition to the grim tally of lives lost to the country’s opioid crisis since 2007: an estimated 88,000 and counting.
There’s another, less discussed, statistic that Mr. Fairchild’s death represents.
For nearly three decades, he worked in the construction sector, first as a labourer and apprentice welder, then eventually as a nationally certified journeyman, logging thousands of hours on energy and infrastructure projects across Canada. The very day after Mr. Fairchild died, he was scheduled to work a shift on a welding project in downtown Ottawa.
With some data showing that the broad occupation category of “trades, transport and equipment operators” accounts for as many as one in five unregulated drug deaths – the vast majority of which involve opioids – that makes Mr. Fairchild one of thousands of workers in that sector to have died nationwide.
“The average opioid victim is not a marginalized drug user, it’s someone with a job,” said Alexander Cheung, whose research as a graduate student at the University of Alberta resulted in a 2023 study analyzing the lost productivity from the opioid crisis. In other words, what is the collective lost potential output of so many lives cut short, as measured by their lost earnings? Drawing on B.C. data that showed two-thirds of opioid victims were employed within the last five years of their lives, he calculated national lost productivity to be at least $8.8-billion for those who died between 2016 and 2019.
For families and friends of those victims, the personal toll is immeasurable. And some may argue that to put a dollar figure on their deaths is cold and dehumanizing. Yet there are very good reasons to quantify the economic burden of the opioid crisis and understand what we all lose when a life is lost.
Beyond the unquantifiable emotional impact, the continuing toxic drug crisis has material costs to the health care sector, the justice system and social services. For politicians and policy makers, money talks, and measuring the fiscal impact of the epidemic makes the crisis harder to ignore.
“There’s always this unfortunate belief that if we let a person who uses drugs die, well, there’s no loss to society because they’re not contributing to society,” said Mr. Cheung, who now works for the Yukon government’s health and social services department. “But by not saving these people, it has an impact beyond the personal tragedy. You’re in fact harming the economy.”
No industry has experienced this compounding loss more than construction and the trades – jobs dominated by men, who account for three-quarters of all opioid deaths in the country.
It’s difficult, often dangerous work. In 2023, the industry was responsible for 20 per cent of all workplace fatalities, even though it accounts for just 6 per cent of all jobs.
Mr. Fairchild’s own tragic journey through injury, pain and addiction exemplifies the dangerous outcome when a workplace culture that encourages physical stoicism meets the onslaught of readily available toxic fentanyl.
As part of Poisoned, a series exploring how the opioid epidemic has impacted the country, The Globe spoke with workers, companies, unions and health researchers, in addition to Mr. Fairchild’s family and closest friend, to understand the grip the crisis has on the construction industry.
One 2021 study in Ontario found that, of those people who were employed when they died of opioid toxicity, one-third worked in the sector. In B.C., close to half who were employed when they died last year from unregulated drug deaths had jobs in the “trades, transportation and equipment operator” category, according to the B.C. Coroners Service.
Making sense of that dynamic is more important than ever. In response to the threat from the trade war with the U.S., Canada has embarked on the most ambitious campaign of infrastructure and housing construction in generations. It will require a massive ramp-up in employment in the trades, testing the industry’s ability to confront the attitudes and practices that have left it so exposed to the crisis.
None of this is lost on Mr. Fairchild’s family.
Mr. Fairchild was 48 when he died, and a father to a 16-year-old son. Charming and boisterous with friends and strangers alike, in better times he played guitar in a band, liked to write poetry and painted watercolours.
“He was larger than life, with this booming voice,” says his older brother Rob Fairchild, with whom Michael was living before his death. “He always had a joke or something to say, but he loved hearing other peoples’ stories.”
The Fairchild family shared his story and the horrible toll his illness exacted on those closest to him in the hopes it helps others facing the same plight.
In Mr. Fairchild’s obituary, they highlighted research showing the disproportionate impact the opioid crisis has had on construction workers.
And they issued a plea to others who work in the trades: “find professional help for your physical and mental pain.”
Growing up near Smiths Falls, Ont., Mr. Fairchild was rambunctious and had trouble focusing in school – his brother suspects he suffered from undiagnosed attention deficit hyperactivity disorder, which Rob himself was diagnosed with as an adult.
But Mr. Fairchild fell easily into the world of welding, enthusiastically embracing the studies and coursework despite having dropped out of high school. In the late 1990s, the oil boom and the large paycheques on offer lured him west, and he would make several journeys to B.C. and Alberta over the years to work on major projects, including Suncor Energy Inc.’s Firebag oil sands project.
It was after one of those trips to Alberta in 2008 that Matt Green, Mr. Fairchild’s best friend from high school and also a welder who worked with him on projects across the country, first heard him talk about prescription opioids. “Doctors were overprescribing them to their patients for anything and everything and he had two or three different people he could easily get pills from,” said Mr. Green. “It was Alberta that destroyed him, basically. That’s where it started.”
It’s not clear exactly what injury led to Mr. Fairchild’s introduction to prescription opioids in the form of the painkiller Percocet, which contains oxycodone, a potent synthetic opiate. At one point he suffered appendicitis at a work camp, after which he was prescribed the pain medication, his brother said. He’d begun to experience back pain from the heavy lifting the job entailed. A dentist also prescribed the drug because of his bad teeth, Mr. Green said.
By then, Mr. Fairchild – a pot smoker back home – had also begun using cocaine. Marijuana takes longer to clear the body than other substances, so it’s common for workers to turn to alcohol and harder drugs while on their downtime to avoid testing positive when they return to camps.
When that drug wasn’t enough, Mr. Fairchild turned to crack. “He’d use the opiates to come down from the crack. It would make him sleep or rest,” Mr. Green said. “They were his two demons.”
The last project the two men worked on together was the Forrest Kerr hydroelectric project in northern B.C., around 2015. “It was 12 hours a day for 43 days straight,” Mr. Green said. Like all construction camps, the site was ostensibly “dry,” but workers still smuggled in alcohol and drugs. “He looked rugged, tired, worn out, older than he should have.”
Mr. Fairchild eventually moved back to Ontario permanently in 2016, where his addictions deepened, even as he continued to work regularly at welding companies in the Ottawa area. “When you drove around with him, he loved pointing out work he’d done years ago,” Rob said. “After his son, this was how he saw his biggest impact on the world: these things he’d fabricated or repaired or installed.”
Yet the injuries were piling up. At work he often carried lengths of heavy steel pipe up stairwells, and spent long stretches of time hunched over pipe focused on his welds. Mr. Fairchild suffered from constant hip pain and bad knees, and he admitted he could barely lift his arm over his head some days.
Despite that, it was a point of pride for him that he didn’t take sick days. “He’d walk around trying not to show that he was limping or reveal his pain,” Rob said. “The one thing my brother was always really afraid of was looking inwards and admitting any kind of mental or physical troubles. For him, it was like admitting weakness.”
One day this spring, as Mr. Green drove his friend through downtown Ottawa to the latter’s job site, Mr. Fairchild looked out the window at individuals openly taking drugs, bent over in the so-called “fentanyl fold,” or lying unconscious on sidewalks. “The only thing that separates me from these people is I have a job,” he said.
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Mr. Fairchild’s belief that being employed somehow safeguarded him from the fate of addicts on the street was hardly unique. Only when the opioid death toll began to mount last decade did attention seriously turn to the linkages between the crisis, the job market and the economy.
The earliest attempts to quantify those connections began in the U.S., where opioid deaths hit harder and earlier than here.
That work helped shed light on a mystery that had confounded economists: the stubbornly falling U.S. labour participation rate since the turn of the millennium. The answer had a lot to do with opioids.
For every 10-per-cent increase in local opioid prescription rates in the U.S. between 2001 and 2015, the labour force participation rate of prime working-age men dropped by 0.5 percentage points, according to an analysis published by the Federal Reserve Bank of Cleveland in 2018.
Put another way, higher opioid prescription rates were found to account for roughly 44 per cent of the 3.5-percentage-point decline in the participation rate of prime-age males over that time period.
To understand the opioid epidemic’s toll on the economy in Canada, researchers looked at potential lost labour output, using what’s known as the human capital approach to estimate the foregone earnings between when a person succumbs to an opioid-related death and when they would have retired had they survived.
Lost productivity is just one of the costs the CCSA looked at in its study, which also took into consideration other psychoactivesubstances.The survey also looked at costs accrued to the health care and criminal justice systems, disability expenses and costs such as property damage. Factoring in all those elements, alcohol and tobacco are a bigger overall burden on Canada’s economy.
But when it comes to the specific question of lost potential productivity, opioids now lead all other substances.
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Unlike illnesses related to alcohol and tobacco, which tend to hit at an older age, opioids claim victims when they’re relatively young. Two-thirds of those who died last year from opioid-related causes were between 20 and 49 years old. “You’ve got people dying of opioid poisoning at a much younger age, and that means a lot more years of productive life lost,” Ms. Kent said.
To see how the cost of lost productivity has grown since 2020, the last year for which the CCSA has available estimates, The Globe calculated the average annual inflation-adjusted cost per opioid-associated death between 2007 and 2020, using the CCSA’s death counts, then multiplied that by annual death counts compiled by the Public Health Agency of Canada since then. (The CCSA includes a broader count of deaths than PHAC, ascribing a portion of fatalities from causes such as impaired driving and blood-borne illnesses from injection-drug use when opioids were involved.)
It’s worth noting the $60-billion tally for lost productivity dwarfs the roughly $175-million Canadian governments and individual plaintiffs have extracted from the pharmaceutical industry in settlements.
In the largest settlement in 2022, Purdue Pharma (Canada) agreed to pay $150-million over seven years to the federal, provincial and territorial governments for its role in the development, sale and marketing of OxyContin, an opioid-based pain medication.
The B.C. government is leading a number of other national class-action lawsuits against other companies related to the opioid crisis but those cases are still continuing and the allegations have not been proven in court.
Meanwhile, health experts continue to fill the data gaps in Canada. “A lot of the research on the role of occupations in the opioid crisis has essentially come from the States. We’re just starting that work in Canada,” said Dr. Nancy Carnide, a researcher at the Institute for Work & Health, who co-authored a study published last year that looked at 13,700 opioid poisonings among 1.7 million people in Ontario who received workers compensation for injuries between 2006 and 2020. (The data do not identify whether the poisonings were fatal or not.)
The researchers found that among construction workers, the risk of opioid-related poisonings was 57 per cent higher than all other people looked at in the study, though there was a wide range within that sector: The risks among roofers, insulation installers and concrete finishers were all considerably higher, while electricians were far less likely to experience a poisoning than the overall population.
As for welders, workers faced a 41 per cent higher risk of opioid poisoning.
Spreadsheets aside, Rob also thinks a lot about the potential that was lost with his brother’s death: “He should be thriving, he should be hanging out with his wife and son, barbecuing steaks in the evening and doing the things he wanted to do and being the person we all just adored.”
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For construction companies already navigating labour shortages, the opioid crisis has shaken the industry.
“It’s like an apocalypse,” said Scott Menzies, the owner of a coating inspection company in Hamilton.
A recovered addict himself, Mr. Menzies got sober in 2018 with the help of a 12-step program. When the pandemic hit, he enrolled in a two-year diploma program for addiction and mental-health counselling at Centennial College.
While there, he launched Hard Hats, a peer and employer support program, and he’s now partway through a psychology and social work degree at Redeemer University, a Christian postsecondary school in Hamilton. “I was dying and I was helped, and now I need to help people,” he said.
As for the economic impact of the crisis, it’s a topic he feels torn about.
“I completely understand why we need to put dollars on this, but my heart always tells me that these are people’s lives we’re dealing with,” he said.
That said, he estimates addiction and mental health issues now amount to at least 1 per cent of all costs in the construction industry. “If you have 10 people on a job site and five just don’t show up, how do you quantify that?” he said.
Lee Woods, the chief executive of Eastern Partitions in Ajax, Ont., has also seen the opioid crisis and its impact on the industry close up.
When he launched the company, which supplies and installs public washroom accessories, one of the first employees who joined was a friend with a known opiate addiction. Each Wednesday he would leave to consume a dose of methadone, a painkiller used to treat addiction. But after three years on the job, his situation deteriorated. After the worker challenged Mr. Woods to a fight, he was fired.
Today, to supplement the company’s 22 full-time employees for large projects, he taps labour supply companies for temporary workers. Many of them have struggled with addictions. “We’ve had guys we hired temporarily and then you see them sleeping in the warehouse, but they’re not sleeping – they’ve taken something,” Mr. Woods said. “I didn’t experience half as much as this 20 years ago.”
It’s unclear how much Mr. Fairchild’s employers and co-workers knew about his plight. Rob says at his brother’s funeral, some who’d worked with him said they were “completely blindsided” by his death.
Mr. Fairchild’s last job, which he started in the spring, was with Modern Niagara, a large Ottawa-based contractor that hires its tradespeople through local unions. The company declined an interview request, citing respect for Mr. Fairchild’s family and privacy. But in a written statement, Lane Campbell, a senior vice-president and Ottawa area manager, said Mr. Fairchild was “a valued part of our team” and that the company aims “to ensure that all workers have access to mental health and wellness resources.”
To help the industry navigate the hiring needed to meet the government’s ambitious infrastructure plans, Canada must recognize the opioid epidemic for what it is – a mental-health crisis, said Carmine Tiano, director of occupational services at the Provincial Building and Construction Trades Council of Ontario, an umbrella group for 15 skilled trade unions.
“We lack a public-health framework that deals with the urgency of this challenge,” he said.
By some estimates, as many as 500,000 new workers will be needed in the sector by 2030, and that’s on top of replacing the more than 270,000 construction workers who are expected to retire by 2034.
The hiring surge represents immense investment for employers and unions, said Mr. Tiano, including the costs of putting a worker through apprenticeship and continuous training.
“Over a tradesperson’s career, you’re looking at close to $1-million invested in these workers in real money and in-kind,” he said. “If you’re investing that much in that person, why would you then have a substance-use problem or a mental-health episode take them out of the industry?”
There are some hopeful signs things are improving, albeit slowly.
Construction unions and industry groups have made Naloxone kits a standard part of many work sites over the past two years. The emergency injections counter opioid overdoses and have been credited with helping to bring down opioid deaths over the past two years.
Yet while the number of opioid-related deaths in the first quarter fell 32 per cent from the year before, to 1,377 nationwide, in some parts of the country paramedic calls continue to rise.
It’s also important to realize that even as opioid deaths decline, the crisis continues to remove an unknown but potentially large number of workers from the labour force, some for good. There are no national estimates for how many people in Canada are dealing with opioid addictions, but one B.C. study found 1.9 per cent of people there aged 12 and older had an opioid use disorder in 2017, nearly double the rate of 2000. Many workers in the construction industry can point to former co-workers who are alive but no longer working because of their addictions.
The Naloxone push is a good first step, but there need to be more resources available to workers, said Sean Martin, director of operations at ReiMar Forming and Construction near Hamilton, which employs up to 500 people depending on the size of projects. “Just telling people, ‘Here’s what you do when somebody ODs,’ is the smallest Band-Aid you could possibly put on this,” he said.
With workplace insurance programs motivated to get injured workers back on the job as quickly as possible, he said physicians are still too quick to prescribe rest and painkillers. “What workers really need is physiotherapy to help treat their musculoskeletal issues and not something that’s just a mask to take the pain away,” he said, noting the company has encouraged dozens of workers to seek support from De Novo, a substance-use treatment centre that serves Ontario’s unionized construction sector.
Others touched by the crisis say industry culture and work practices need a complete overhaul.
Lorna Thomas, whose son Alex Thomas-Haug was a welder in Alberta’s oil and gas sector, co-founded the group Moms Stop the Harm, a network of families who’ve lost loved ones to substance use. Alex died by suicide in 2012 at 24 after struggling with depression and addiction.
“The language in the construction industry around opioids is really focused on the individual, but from my point of view it needs to shift on to workplace safety,” she said.
This week, she and Moms Stop the Harm chair Traci Letts presented the results of an informal survey of the group’s 2,500 members at a CCSA conference in Halifax. The survey found 45 per cent of victims were employed at the time of their death, while another 32 per cent had been employed at some point in the last 12 months of their lives. Two-thirds worked in the construction sector.
The survey also found many victims faced workplace pressure to “be a man, don’t display weakness,” said Ms. Letts, while there was widespread reluctance to seek help from employer programs because of the stigma around addiction and the risk of being fired.
In the meantime, a new peer-to-peer support program in B.C. aims to break down the social and psychological barriers that prevent trade workers like Mr. Fairchild from reaching out.
The Forge, created by the Construction Foundation of British Columbia, features a team of tradespeople who have experience with mental health and addiction challenges and who have undergone peer-support training. An app, to be launched in December, will include their photos, bios and contact details for workers to reach them anonymously.
“It’s basically hope on two legs,” said Trevor Botkin, a former construction worker and recovering addict who is involved with the project. “You won’t be judged. The peer support workers are hard to scare. These guys have been through it.”
The organization is also looking to sign up construction companies to a program that will enable trained employees to connect the Forge’s peer support staff to co-workers who may be quietly struggling. He said it’s often the case in overdose deaths and suicides that “everybody knew something was up, but we didn’t know what to do about it.”
One of those support workers is Shawn Underhill, who spent three decades in the industry as an ironworker and, like Mr. Fairchild, developed an addiction to crack and used opioids after a series of injuries in work camps.
“I’m very lucky to be here,” said Mr. Underhill, who before going to treatment was consuming an 8-ball a day of coke, or one-eighth of an ounce. “You’re living a death sentence when you do that.”
What motivated Mr. Underhill to eventually seek help was the sheer number of friends and family he’s lost. He believes he’d have reached out for help sooner if there’d been someone “who’s also been through the junk before.”
The goal, says Mr. Botkin, isn’t about putting pressure on workers to abstain.
“Our industry’s relationship with substance use is as old as the first hammer, so the question is, why are we dying at such an alarming rate from opioids? Because fentanyl is a game changer,” he said.
“My mission in life is not for people to quit drinking or doing drugs. My only mission is, don’t die.”
Just one month before Mr. Fairchild overdosed, his brother told him about an acquaintance who stubbornly refused to seek help for his own mental-health troubles. “Oh, I agree,” replied Mr. Fairchild. “I would literally rather die than go to therapy.”
Mr. Fairchild’s relations with his family and friends grew strained in the final months of his life as he became increasingly paranoid and evasive.
Mr. Green had confronted his friend about his addictions and attempted interventions over the years, but when he did so again this past summer, Mr. Fairchild grew angry and began avoiding him. He remains wracked with guilt, thinking that he could’ve done more to help Mr. Fairchild. “This has been a nightmare,” he said. “He was my comrade.”
On the day Mr. Fairchild died, he and his brother got into an angry fight that evening. It was about money. It was about lies. It was about Mr. Fairchild smoking crack in his brother’s home. Rob kicked him out, telling him that when Mr. Fairchild was ready, he’d be there to help. Mr. Fairchild’s last words to him were “fuck off.”
At 2:45 a.m., Rob’s phone rang. It was his sister, in tears, calling to tell him the police had just notified her Michael was dead.
“There’s no weakness in saying you need help. It requires tremendous courage,” Rob said. “My brother just could not say, ‘This is beyond me. it’s more than I can fix by willpower, and I need help for all the pain.’ Had he done that at any point in his life, possibly in the days before he died, he might still be with us.”
Earlier this week Mr. Fairchild’s family came together to bury his urn at the foot of his father’s grave, and Rob gave Michael’s wife and son his welding helmet and gear.
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