The SiteVisit

Confronting the Opioid Crisis in the Construction Industry with Effie Argyropoulos from Digital Public Square

• James Faulkner

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Effie Argyropoulos from Digital Public Square joins us to shed light on the pressing issue of opioid use in the construction industry. Through her insightful discussion, discover how their innovative digital tool Level Up not only raises awareness but also provides critical resources for intervention in a sector hard-hit by opioid-related deaths.

Uncover the complexities of managing chronic pain amidst the backdrop of labor-intensive industries, where personal stories of prescribed opioid use for injury recovery highlight the challenges faced by workers. We explore the workplace stigma associated with substance use, emphasizing the fears of job security and safety concerns on construction sites. We look at the role of Level Up as a preventative measure, aiming to support individuals within the framework of safety and health, balanced with the employer's responsibilities and liabilities.

Engage in a discussion on fostering open communication in the workplace, essential for supporting mental health and resilience. Effie gives a compelling narrative on the importance of empathetic, evidence-based policies and the need for systemic solutions that empower both employers and workers. By focusing on the intersection of politics, policy-making, and the opioid crisis, we address the broader societal factors at play and highlight the urgent need for understanding, compassion, and collective action in creating a healthier construction industry.

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Speaker 1:

you're here from Toronto today, so you say it's sunny there.

Speaker 2:

It's very sunny.

Speaker 1:

Very sunny. Well, that's not here. It is dark and raining like hell.

Speaker 2:

Yeah, I'm so sorry to hear that. I will say the tables are going to turn so quickly in terms of the temperature and the comfort zone that you can rest assured you'll be the ones laughing in due course.

Speaker 1:

So we're going to be talking about your organization called Level Up, the Level Up tool, which we're going to talk about specifically, and then all of the underpinnings of the motivations of doing this and what this initiative is all about. I don't know what is in Vancouver. I know that you know we're going to be talking construction and you know opioid use, et cetera, et cetera. But I'm just curious in terms of the sort of street version of opioid use in Toronto, does that change a lot in the winter?

Speaker 2:

You know, I think the challenges are that the calls to action are a little bit stronger, just given how intensely cold it can get at the heart of winter. Certainly from an anecdotal perspective, you see these pleas to get folks who might be unhoused into care, into some kind of shelter, in those really, really cold moments, and you don't hear too much outside of that. That's not to say there aren't brilliant organizations doing incredible work, but that kind of widespread PSA is really, at least to me, something that seems heightened in those frigidly cold moments.

Speaker 1:

Yeah, well, our hearts go out to everybody who's out in the cold and in the terrible weather and hopefully policies and your organization and everyone can get their act together so people don't have to live like that. Totally.

Speaker 1:

Welcome to the Site. Visit Podcast Leadership and perspective from construction with your host, james Faulkner. Business as usual, as it has been for so long. Now that it goes back to what we were talking about before and hitting the reset button. You know you read all the books, you read the emails, you read Scaling Up, you read Good to Great. You know I could go on. We've got to a place where we found the secret serum. We found the secret potion.

Speaker 2:

We can get the workers in we know where to get them. One time I was on a job site for a while and actually we had a semester concrete and I ordered like a Korean finished patio out front of the site show.

Speaker 1:

yesterday I was down at Dallas and a guy just hit me up on LinkedIn out of the blue and said he was driving from Oklahoma to Dallas to meet with me because he heard the Favourite Connect platform on your guys' podcast. I'm a crusher from London and we celebrate these values every single day. Let's get down to it. Effie Argyropoulos.

Speaker 2:

Yeah.

Speaker 1:

Wow, I got it. I can't believe it. I did practice.

Speaker 2:

You did a great job. Not everybody's so smooth.

Speaker 1:

Yeah, so let's just talk about the level up tool. I've been to the website, just tell us about the structure, the organization, kind of how this all came together, and let's just start there Sort of how did this all get?

Speaker 2:

going Square.

Speaker 2:

We're a Canadian not-for-profit.

Speaker 2:

We are based in Toronto, we have folks in Vancouver, in Ottawa, and historically always worked on democracy, human rights work, internationally, and with the influx of the COVID pandemic we started to see that our model for misconception, revision, for awareness raising, was really applicable to public health contexts and that's where I joined the team. I have a background in public health. I worked for a number of years in local government public health out in the UK and my background in community engagement helps me work now to inform health interventions. So I would say we definitely have a much more established public health project portfolio here at DPS. That's what I lead at the organization here and really Level Up came out of a call for funding that we responded to through Health Canada's Substance Use and Addictions Program, where we saw a niche need in the construction industry, specifically for men working in construction. Given that they make up 75% of opioid-related deaths, we wanted to hyper-focus in on that target audience and build something that could deliver good information and help people know what to do when they're faced with a difficult problem.

Speaker 1:

Okay, so let's just get into the specific, the tooling of this and what the solution is for people in construction. For what exactly? So what is the sort of end product, end solution that you guys are offering?

Speaker 2:

So what we've built and I'd be happy to share a little bit about how that came to be built but what we have built is a digital health promotion tool, the view being it's operating in a prevention space. So we want to raise awareness among this audience. Our research showed that there was a gap in their knowledge about how serious of an issue this really was in the construction industry. We know that, of people employed at the time of their death in Canada, 30% to 50% work in some kind of labor-intensive industry. So that's quite serious, especially when we're looking at 21 opioid-related deaths per day across the country. Quite serious, especially when we're looking at 21 opioid-related deaths per day across the country.

Speaker 2:

So we ultimately developed a tool that both delivers bite-sized information to help raise that general awareness, but also signposts people to useful information for how they might be able to be an ally. So what I mean by that is not only providing them with information on how to spot an opportunity to have a conversation when they might notice someone might be struggling. It gives them some tips on how to broach that difficult conversation and also gives them the knowledge of existing support services that might be necessary for more complex needs, which we think of as further along a prevention pathway and allows them kind of a one-stop shop to be able to do that. So it's not just raising that general awareness, which is an important aspect of this, but it's also having a kind of embedded directory of existing harm reduction, withdrawal management, detox services that someone could pull up at any given moment and find support for themselves or for someone they know in their local area.

Speaker 1:

Okay, so in order in in terms of the like, do you guys have like a it's a questionnaire thing, is it a mobile app or like what's the sort of interface?

Speaker 2:

in order, for that's an intentional decision. We want to make this really accessible. We don't want to.

Speaker 1:

I've got some people on site and you know it's kind of a I don't know, I think there's what do they call it, the three Ds dirty, dull and dangerous. Those positions out there can obviously, you know, are sometimes lower paid as well. Let's say, I have somebody who I think, I don't know, it doesn't seem to be right past couple of weeks, or whatever it is. Do I go onto this website? Which button do I push? What do I do as an employer to sort of get?

Speaker 2:

someone help? That's a great question. What I would say in that instance is I would look to either how to support someone. There's a learning pathway there. There's also some resources like quick tips and links, both of which would get you to a supportive conversations library and through there, an employer, a peer, someone who cares about somebody that they fear might be struggling, could get a little bit more information about how to broach that difficult conversation. I do think it's important to stress that this tool was built with the worker in mind, so, while we really want to leverage the opportunity that employers can hold in this space to make a positive impact, the tool itself is built with the worker in mind and trying to cater to their specific needs.

Speaker 1:

Okay, so the hope is that if someone is struggling, that they themselves will go onto this website.

Speaker 2:

Either if they're struggling or earlier. We know this whole group is at a higher risk of potential opioid-related harms higher risk of potential opioid-related harms. So if we can get folks to be engaging with it early, before there might even be a problem or before problems get worse. That's really what we mean by that prevention angle, but noting that we kind of need to meet people where they're at. We have built in features into the tool and by that I mean kind of built-in key information points that if someone might need access to more complex care, there's a pathway there for them to get more streamlined information than what currently exists. If you were to do a Google search.

Speaker 1:

Okay, so can we. Just can we zoom into that one statistic of 21 opioid deaths a day throughout Canada? So can we. So can we get to first principles on that. So, when we're talking opioids, what are we talking about specifically? Are we talking about somebody taking Percocet for pain, or are we talking about someone smoking fentanyl on the street?

Speaker 2:

It could be both. It could be both or either. That's part of the awareness raising piece in this.

Speaker 1:

I don't know if everybody realizes even that a Percocet is an opioid. In Vancouver it's the downtown east side pants halfway down their ankles trying to be a gangster, narcissism, all of that. It's not that. This is something totally different. So the 21, how many of that 21, what percentage, are in construction, pain management, and it went sideways.

Speaker 2:

That's a great question. I wish we had that kind of granularity of data. It's really challenging to record that.

Speaker 1:

It is, but I mean, it is kind of the subject that matters.

Speaker 2:

It is.

Speaker 2:

It is Absolutely, I think, what's important here, and the approach we've tried to take is twofold.

Speaker 2:

We absolutely recognize that there's a significant pain management component to this, and by no means would we want to discourage folks from seeking pain management or have them living in pain because they're too shamed to have relief from it, and so some strategies we might offer within the tool itself are prompt questions. You can ask your doctor when you are prescribed a medication for pain, so you as the consumer can get a little bit more information, so you can understand the implications that going on this medication and, in turn, coming off of this medication might have. What we heard from our own research was there was this kind of overarching trust that if my doctor tells me to take it, I'm going to take it, no matter what it is. But we want to give people that agency to inquire a little bit more and better understand. We don't want to contribute to the stigma of a dichotomy between a good drug user and a bad drug user. At the end of the day, everyone's a person and they deserve support.

Speaker 2:

Um recognizing, of course, the unique circumstances that labor workers find themselves in and trying to cater information accordingly to that but, also um, if there were someone on the Vancouver downtown east side that could benefit from information in this tool, that's one more person that benefits. It's just that that persona wasn't the focal point of what we developed the intervention around.

Speaker 1:

Yeah, it's interesting like that. I so a number of years ago I broke my leg badly in an ATV accident and I was on morphine in the hospital, all that kind of stuff, and then through my recovery, I was given Percocet and I remember at 9 o'clock each night I I'd be like, okay, here we go, let's have that. And it was amazing. I felt I was in a better person who is perhaps in a skilled trade and it's very hard on the body and I've hurt my back and it's the same thing. So in terms of stigma, it doesn't seem like there would be any stigma around something that has been prescribed by a doctor or a hospital or something like that. That's just a pain management thing.

Speaker 1:

Some people have an addictive personality. Unfortunately, I was able to just be like, oh, I guess the prescription is done, okay, finished, I didn't go out and seek that ever again, et cetera. So you could say that maybe DNA-wise I'm lucky I don't have that addictive personality thing. I was able to just say, I see later Some people might not have that and there might be other life, situation, situational things going on where there's additional emotional pain as well. So the injury is just the thing on the top. It's like the thing that's, and once the pain goes away for the body, the pain for the life circumstances hasn't gone away either. So it ends up in this reason to continue on with that opioid.

Speaker 2:

Yeah, I think. I mean, it's so difficult to generalize and everybody has their own experiences with pain and experiences with pain management. But I think one thing that's been acutely pointed out to us in our own primary research in developing this intervention was the nature of this work. It's your financial security is tied to your ability to continue on in this work.

Speaker 2:

And so even if what is in your best interest in the long term is taking some time out to cope and rehabilitate whatever injury is causing that pain, in more instances that's not feasible for a number of reasons. And then the implications on one's mental health that chronic pain might have are. It's impossible to decouple that from the physical element of it. So it's certainly very complex. It's certainly the fact that the nature of this work fundamentally invites a bit of a challenge. What makes it that much worse is that in so many construction companies, lots of workers have to sign waivers stating that they won't be on opioids. So even if they are prescribed opioids from a doctor through the regulated market, they suddenly have this legal obligation not to go on them.

Speaker 2:

And so what then becomes the solution? And it creates this whole element of stigma within a workplace. You know, in our research we had surveyed 700 labor intensive workers in Canada in September of 2023. We saw 76% of them indicate that they would worry about losing their job if they needed to get help for substance use and only 37% said they'd feel comfortable talking to their employer. So there's this kind of industry-specific stigma or barrier to accessing support that we just can't ignore in this audience really right.

Speaker 1:

So that's brought up a whole bunch of thoughts. So, first of all, so when somebody, um, you know, looks through that orientation and and they get to the point where it says you know, check this box and sign here, you're not on any kind of opioid, blah, blah, blah, at that point is is that's the? Isn't that the perfect place? If you're not on any kind of opioid, blah, blah, blah, at that point is is that's the? Isn't that the perfect place? If you did not tick?

Speaker 1:

This is to link to you guys, and the reason I asked that is because from the employer's point of view, it's just too much liability. Like you can't have somebody around heavy equipment the construction site is a extremely dangerous place somebody with who is not completely um, there's obviously going to be a huge um spectrum of how dosed up somebody is. Because that's because all there's just an admittance of yes, I am on that, but you don't know how hard you're on that, for instance, instance. So you know, and you could be a good actor, or because you could be a very good drug person. Who can? It's not drug person. What a terrible word that is. How would I say it's not? A user is a terrible word too. What would you, what would you, what would?

Speaker 1:

you A person using drugs, repressing, yeah, or yeah, who's using it that time? So you might be good at hiding it. In other words, so it's obviously the reason that the employer has that there is because of liability, of it's dangerous for others too. Let's say they're moving some heavy materials around and then killed somebody else. The employer would be at fault, right? So I, I it's. I don't think it's in terms of a, so I guess the question question to you would be in terms of the word stigma. Is they not checking the box on the form? Is that a stigmatizing question on the job site? I think it's challenging.

Speaker 2:

It's challenging, it's complex, and maybe it's not a dichotomy, it's certainly a barrier, if nothing else, well, it does have to be for safety, sure, sure.

Speaker 2:

And there are safety concerns. You know, and we see that reflected in actual industry, workers' perceptions of opioid use on the job. They recognize the safety concern it poses. But it is complex, it's stigmatizing insofar as barriers to accessing help perpetuate and adjacent to existing stigmatizing narratives further limit someone from seeking the help they might need. Now you asked if Level Up would be the right follow-on at the point of that box tick.

Speaker 2:

I don't know if that's the intervention point that's most appropriate there. I don't know if that's the intervention point that's most appropriate there. I really see Level Up as a prevention tool first and foremost that also nods to someone who might be further along their recovery journey and makes sure to give tools to whoever is accessing it, be it the person themselves or someone that might want to help them, to help them through that space, might want to help them to help them through that space. Certainly some information about pain management that the tool offers could be a useful piece then and there. But I think at that point an employee already on opioids starting new work and disclosing this with their employer, this with their employer there's so many, there's so many particulars there I would I can only feel that we'd need to stress that that be a case by case piece.

Speaker 1:

Yeah, as you can see, I mean I think you know from us, you know making software and doing and having. You know we see these forms all the time, these site orientation forms, you know these onboarding forms. We see all that stuff and you know we have a safety component to our software and I just see this from the specific tactical side of things, on what companies are doing just for their safety policies. So that's, that's just that. That's the only reason I asked that question is it just seems. It just seems like like that would be, like I think what you're doing is really, really important and I think there are different levels where you guys can get involved, you know, or where the initiation of your services or your initiatives can help these people.

Speaker 1:

You know, I, because it is worrying. The question is is if somebody doesn't tick that box and just and they say, well, sorry, you can't work today, well, that's to me that's the perfect time to be like let me take you aside and I think you need some help here, maybe, because otherwise where are're going to go? They're just going to go home without pay for that day, be upset and you know they might take another pill for that pain, for that, you know I mean it's to me, that's absolutely and and that's where I think the the there needs to be an additional element from the employer side in that space.

Speaker 2:

You know, pain is real and pain management is real and recognizing absolutely the safety concerns, how do we create, how do we empower employers through different mechanisms, maybe through the data that certain interventions can yield those individual workers in their rehabilitation journey, so that it doesn't become a dichotomy between exist in crippling pain or don't get paid.

Speaker 1:

Yeah, well, I think what you. So you said there was some federal funding that you guys were for this program.

Speaker 2:

Yes, this program is a Health Canada Substance Use and Addictions Program grant.

Speaker 1:

Yeah, because the difficult part I'm finding what construction is burdened with at the moment is, you know, there's a mental health crisis with construction. There is a suicide crisis in construction and now there's this opioid use epidemic as well. So the question is is who has to pay to fix this? Because the construction, I can tell you, at a general contractor sometimes they're working at maybe 5% margin on a job. So if everything goes wrong on a job, they actually pay for the project out of their own pocket. That's how risky it is. And they get paid by the developer and the developer.

Speaker 1:

I'm just going down the sort of stratas of where the money comes from and who has to pay. Because at some point we're saying you know, if someone's on site and all this is happening, you know this is the time to do these things and have these programs. Well, they're not free. Nothing is free when somebody's you're using human resources, employees, time you're using in order, employees' time You're using in order to help that person. Obviously from an altruistic point of view, yes, these are human beings. Everyone wants to help everybody. They do. But this isn't a playground and this isn't sports. This is business. Part is people need to be able to find how the government can help them once, so that there needs to be uh training wheels here from the government to help fix this.

Speaker 2:

The government started this problem in the first place so it's a it's a really fair point and it's super interesting. I think there's a lot of power in what we can generate through people engaging with tools like this, with other tools, with understanding from the workers themselves where the needs are and where those barriers explicitly lie. Only from there can we start to see employers advocating for their needs and, in time, through Look, I'm not a financial analyst. I wish I had a magic wand and could demonstrate what the ideal pathway was for how we fix this problem with money and whose money that's actually going to be. Yeah, but I do think that there's so much impact employers can have that's undeniable, yeah, and so policies that could be put in place to further support employers be able to be the best impact they can possibly be on their staff would no doubt be invaluable to this audience.

Speaker 1:

That's exactly where I'm going. So we're totally on the same page here, because if you empower the employer to get that person into a program that's at the right stage of the sort of crisis that that person is in at that point, then we've helped right away. There wasn't a push off till later. There wasn't a oh, we'll just go home. Then there was some kind of a place where they it's basically triaging on multiple levels.

Speaker 2:

Totally.

Speaker 1:

And what I find interesting about this is I know this is going to sound kind of macro, but we're saying how do we fix this problem? The reason this problem exists in the first place is a symptom of our culture. It always does. You know, canada is a tribe of people and the tribe has this problem. Well, how did it happen? Well, behavior created it. It doesn't just happen by itself. So the question is is what have we done? How do we unknit this problem? We've got, we've got this knitted ball here. We've got to figure out how do we knit this in the first place? What did did we do? Maybe you can go super, super macro with it.

Speaker 1:

Maybe it's the big disparity between the haves and have-nots has gotten bigger. Housing prices are expensive, people are depressed. There's so many factors of why people are moving towards substance use in general and it's very difficult. You know, what I find interesting is I think I said this in the last podcast we had with the BC Construction Roundtable is any program that the industry in construction has to pay for. We just made apartments go from $800 a square foot to $850 a square foot and it all it does is every time everything costs more money to do construction.

Speaker 1:

It keeps pushing. It keeps pushing things further away from people and it's really hard. It's really hard to. It's hard to deal with that when developers all they're trying to do typically is run a business. They're trying to build a project with profitability, to the point that actually was worth their time.

Speaker 1:

You know they're not doing it for fun, they're doing it for business and the general contractor is trying to service that developer and trying to do a good job and the sub-trades are trying to service that GC and all of the labors underneath are trying to work for those different organizations. And I've said many times, if I was a site worker and my body hurt and I had other life financial problems, every paycheck I get basically just goes to the ether because my credit cards are maxed. All of these kind of things and these are the kind of life situations that you know can contribute to people, you know wanting to use opioids for getting their mind to be calm, because it's just so crazy. The individuals who are on the job site are building, even if it's not an expensive housing development or condo development, maybe it's even a non-profit they still know that they would never be able to afford to get in there. Just imagine that feeling building something you know you can't use.

Speaker 2:

Of course, I think you make a good point to say that all of these industry stakeholders are, at the end of the day, a business and they're seeking a profit. But I think we have so many examples, time and again, where the health and well-being of your workforce directly relates to more positive outputs, to better outputs, to better, better retention, better work-life balance. You, you, there's so much to say that investing in the health and well-being of your staff, yeah, is an investment in your business. I, I think that's undisputable. Um.

Speaker 2:

One line I that's really powerful to me is and I think it relates to what you were saying about behavior and how we untangle this is the idea of how do we make the healthy choice. The staff is getting support early with their pain, having some time off work so they can rehabilitate properly and make that acute pain go away before it becomes chronic. You can look at it from that employer lens, but you can look at it from a government lens too. You can look to say what policies can be put in place that empower employers or enable employers to make these healthy choices, the easy choices for the people they oversee.

Speaker 2:

And I think with that lens and applying that lens. We can't possibly think of behavior as an exclusively individualistic piece, even though we're all responsible for our own behavior. It's an amalgamation of the world we live in, the experiences we've had or haven't had, and unfortunately that is unequal and it's becoming increasingly unequal. To talk about macro level, but I think it's the role of larger scale institutions like an employer or a government, to be able to put measures in place to try to re-level that playing field and make that divide less stark.

Speaker 1:

I've dealt with a whole spectrum of different kinds of sub-trades and some of these companies just don't have it together as a company and they're going through employees constantly. It's a revolving door.

Speaker 1:

Which from a business perspective isn't doing anything for them. It isn't. But the proprietor of that business maybe is just one of these people who just can't get out of their own way, but they still get a lot of work, but they just can't get out of their own way. That's a lot of companies. So I would totally agree with you on the sub traits that are professional, super positive, super great at everything. They're going to get all of the cream of the crop work and this, this opt-in, you know, help our, and I agree with you wholeheartedly on this. But I'm not disputing that what you're saying. This is a very just, just a caveat. This, this is a very cerebral conversation we're having.

Speaker 2:

It is.

Speaker 1:

And I really enjoy it. And if I'm pushing too hard, it's just because I really care about this and I do like to get the first principles, because otherwise we just never get anywhere.

Speaker 2:

Absolutely.

Speaker 1:

Yeah, let's just say the sub and I say sub trade specifically, because general contractors a lot of them aren't really not all of them are doing any self-performance Right. So you know they're subbing everything out. Obviously they would. All they're doing is taking the developer's money, doing project management, making sure you know they're coordinating the build, and then all of these different companies show up. Who have all?

Speaker 1:

of their own different safety policies. So let's say that the general contractor has this, you know. Are you using opioids, or is every sub trade? Are they asking that of their people all the time? We don't know. So we don't know how well the management of each of those subtrades conducts their business, how well they do that and how good they are with employees.

Speaker 1:

Some of them might be terrible employers for sure but there's so much construction that terrible employers are getting work and that's that's the hard part, like you know, and I I can hear it right now, I can just imagine and we're also the other thing that's and this is an interesting question for you how do you think that the transformation of the generations of construction are related to this in terms of the business, people running the businesses? So you've got, you know, baby boomers now who are retiring, and then you've got the Gen Xers, kind of my generation, who you're probably finding out on this podcast, are very hard people. They are very matter of fact, not fluffy. It's like you know, the math has to work out. It's not two plus two equals five, it's always four. So and and that's the new that are, that, that's the new generation taking over, is the gen x generation taking over from, and then there's also the higher end of millennials who are almost more Gen X-y in terms of because it's a certain amount of years when a lot of stuff got quite coddling.

Speaker 1:

I don't know if you you know, but so that's. So the what is, what are your thoughts on the generations, on how the, the perception or uptake of attitudes in construction are not on the high side, not on the lead course, pcls, all of that? Obviously they're going to be full on. Where do I sign up? Absolutely know XYZGC, you know, who has 20 employees, the uptake of some of those lower strata organizations is most likely where a lot of these problems are.

Speaker 2:

So it's a really interesting question and I don't know the answer. But I can imagine what I do know and what I've seen time and again in our work with people with lived experience this issue, and not only doing so among workers but among those making the decisions at the industry level. I can only imagine that that would be in service of workers. Now I might be biased, because the folks in industry that are engaging with us readily about this tool and are championing it and are distributing it to their union workers and laborers and other workforce, they probably are a little bit socially conscious already. They're not the folks that you're talking about that are get in, get out. So I'm fully aware of my bias in that space. But I've been pleasantly surprised to see the appetite of employers and I've been pleasantly surprised to see the appetite of employers and I've been pleasantly surprised to see the enthusiasm of young apprentices when we go and speak with them, how eager they are to share their thoughts about this, how harrowed they are by some of these statistics, and I see it in their faces. So it may not be answering your question, james, but I guess I'm maybe naively optimistic that there's only more awareness raising about this topic going on. Yes, we hope to achieve that to some extent with Level Up, but it's been going on too.

Speaker 2:

We had our 2016. We had our shows on Netflix. We had our Dope Six. We understand the implications of overprescription on Netflix. We had our dope six. We understand the implications of overprescription and I think the tide is moving in the direction of understanding that toxic drug supply crisis and understanding the intricacies that go into an individual's behavior change, that it's not just an individual's problem, it's a collective problem and it's one that, if we generate collective solutions, we can see much more wide scale impact that benefits certainly people's health, but also people's businesses. So again, I'm not sure.

Speaker 2:

No that's more about the Gen X, but yeah, no, you got that, you got there. I can't say I'm not, I think I am, I am.

Speaker 1:

So when you say that the toxic drug supply, how is this playing into people who are taking pain management?

Speaker 2:

Well, I'll give an example. And if you are an employee of a labor workforce of industry and you've been prescribed opioids by your doctor but you've signed a waiver saying that you're not going to take them, suddenly filling that prescription becomes a liability. How might you seek out pain support? Maybe in time you turn to an illicit market, maybe you look for solutions that aren't going to have that, that following you. And we know the levels of fentanyl and carfentanil in the drug supply are skyrocketing. We know there are people taking drugs recreationally for the first time and dying. And it's heartbreaking and awful and it really has moved from this overdose piece into a toxic drug supply crisis whereby we don't even know what is in those drugs that people are taking. And again, I'm wary of giving that example because I don't like to dichotomize drug use and suggest that one group is more deserving than the other of help, that one group is more deserving than the other of help. But drawing on the example you're sharing, I think that's one we've heard more than once anecdotally through folks in industry.

Speaker 1:

Yeah, Well, it's interesting. I think, obviously on the front end, when I always talk about first principles, first principles will inherently dichotomize those, Because I think behind closed doors and it doesn't mean you do that on your marketing side. But I think, in order to understand the specific needs of the different scenarios, like I do look at, I can quite easily see the difference between someone coming off a job site and I've seen it a few times somebody who's kind of like you know, they seem like they're just hanging on, Okay, the difference between that and someone in the downtown east side with their pants, with their underwear showing and they're going to go rip off and steal stuff from your car. I don't see these as the same.

Speaker 2:

But they're both human beings, are they not?

Speaker 1:

They are, but it's a different scenario entirely. One might end up there for sure if it totally goes unchecked and we don't take care of this situation. But they're not the same situation. One person might have hurt themselves and be dealing with pain and started off that way, and somebody else. I just don't think that they're necessarily a certain thing. I've watched many documentaries on the downtown East side and there is a culture of wanting to be in that like they don't want.

Speaker 2:

Some of them don't actually want help I'm going to push back on that one, in so far as nobody seeks out being crippled by an addiction to drugs, I think. No, no, no, I wasn't saying that.

Speaker 1:

No, I was saying once, once that grabs hold of them, then I'm not saying no one in their right mind would be like hey, I want to go do that.

Speaker 1:

And this was an interview with somebody who said I don't want to go to these houses that they have for us because I have no freedom. I can't do what I want to do. I want to be on the street. The street I can go and do all the stuff. So that's just that situation. All I'm saying is that I in construction, I want to make sure that the work that we do, like podcasts like this, what I'm helping with the nonprofit in Arizona there that we do, the other part is not a construction, because this is a construction podcast. So I want to bifurcate those because I would prefer for those people not to end up in those dire straits is my point.

Speaker 2:

Absolutely, that's all. I see people struggling. I think what's interesting is, you know, I think all drug use starts with people being in pain in some way. Everyone's unique context, with that same level of empathy, and it almost de-stigmatizes any outstanding stigma because, you're right, there's completely different contexts between someone you might see who is unhoused on the street and someone who is struggling through a work-related injury, but at the end of the day they're both tackling a similar challenge. It might be presenting differently, but if we want to dismantle the stigma in industry, we have to remove that concept that some people are good drug users and some people are lost causes. Otherwise, where do we draw the line? Where is the divide? And we run the risk of ostracizing people a little bit. That's my concern. I see the act of removing that dichotomy is not actually making the issue too broad, but rather one step in the process of dismantling stigma. That's harmful to everyone, including people in the construction industry.

Speaker 1:

Right, yeah, I think that one of the reasons of the bifurcation of this is so we're in an image conscious world. These days, everybody's concerned about how they look, how they are perceived to others. It's just this Instagram world we're in. How they are perceived to others, it's just this Instagram world, we're in.

Speaker 1:

And when people are reaching out for help and it's the same thing with mental health. I've talked about this many times is that there does need to be again a bifurcation between somebody who has a mental health issue that is, someone on the spectrum or somebody who has life issues, life issues that are creating pressure. Everyone has those. The developer whose interest rate just changed from whatever percent to whatever percent and is going to lose their house if that project doesn't work, has pressure. Everyone has. Pressure based on things just depends on where it is down the line.

Speaker 1:

So when you have somebody who has I'm talking about it could be anyone in construction who is in over their head from life circumstances. They're making sure that we do not stigmatize life problems by calling it mental health to the point where they think they're broken. They're not. They need help but they're not broken Because the large percentage here it said like the larger percentage of the people who fall in construction here are men, according to your, to your website. And if that's the case, well, why are these men so down and out like what is going on?

Speaker 2:

well, I think it's interesting what you just said around mental health, because why do we need to see it as someone being broken? Maybe that's the stigma in its own right, and if we could dismantle that piece and know that struggling with mental health or pursuing mental health support has a range of reasons, none of which mean someone's broken. It's actually a sign of resilience.

Speaker 1:

Yeah, well, that's kind of what I'm getting at. So, in other words, removing the stigma from help. In other words, right, you know the type of guys that are, you know, kind of atypically masculine, I would say, like pretty out there guys, right, and they don't want to ever look weak. It's just, it's just the archetype. I mean, hey, I could, I could say it's something different, but it isn't so, you know, for all intents and purposes, you know, these, these guys are just like I don't know. I mean, if I go to my employer and I say this, like what are they going to do? Take me off the job? Or like what's going to happen? Like I need this money, I just can't. I just got to keep going, I got to push through, I got to push through. They're listening to David Goggins, it's this whole thing. So there's this culture of being tough, right, and the thing is, is that? So what I'm trying to get those individuals to understand is that there's not. We need to remove the stigma, that things that you're struggling.

Speaker 2:

Totally and I think that's a piece. Imagine again going back to my point on making the healthier choice, the easier choice, as corny as it sounds, but imagine that thought process in an environment that was really open, encouraging and did not suggest that you would have to for repal, were you to raise anything yeah over time. That, coupled with that general awareness of it being okay and actually tackling a problem early, is going to make you more resilient.

Speaker 1:

For longer would go a long way yeah, I think, um, I think it really it it's going to come down to it's. A communication barrier is the main thing here, and I think what your organization is doing well is is breaking down that communication piece, cause the problems are going to stay the problems forever. It's just a matter of how they're communicated and how they're tackled with and making people feel comfortable that they can actually do something about that.

Speaker 2:

Well, totally, and we've. We've really tried to take that privacy angle to heart and for that reason we collect no personally identifiable information. There's no tracking. So people can feel safe engaging with information that maybe they aren't at a place, they can talk to other people about it, but they can for lack of a better word level up their own understanding that much more. And we know in time, even if that doesn't mean that behavior shift happens immediately thereafter. It can happen in time, maybe in a week, maybe in a month, doesn't matter. It's engaging with that information, having those thoughts in one's mind and having a general sense of what a pathway could be. If that struggle starts because that's the most debilitating thing what do you do? Where do you go? That's suffocating. You try to push it down and the problem only gets worse. What if we could let people know what pathways do exist out and they could let it percolate at their own pace without that poke hold?

Speaker 1:

yeah, yeah, that's pretty cool. There were a couple of notes here, things we sort of passed. You know, backwards and forwards. You know what are we going to talk about on this and, as far as I'm concerned, you and I could talk for hours, because I I find this fascinating I'm not, and you know.

Speaker 1:

I think you know when the great thing about conversations like this is we're able to have an open discussion. And you're probably thinking my last guest said you know, james, you're such an absolutist I'm like, well, maybe, but you know, my heart's in the right place. That's the main thing. I think it's heartbreaking. I drive down through the downtown east side and I go how did this happen? That's so upsetting, and my friends will be at cocktail parties and we're all talking about it. Why can't we get this fixed? Like, why can't we get this fixed? And you know, when it comes to you know I'm going to say Josh again in, in general, arizona. You know, I got my my uh, my designer. We paid for it to design his stuff. Um, we don't want any money. Um, you know out to help anything we can do to help you with you guys.

Speaker 1:

Totally, I mean, I think like some kind of a badge campaign that they have on their hard hat that has your organization on there level up. I mean it just needs to get out there and have that message and you guys want us to help. You guys do anything like that you got to let us know, because we're all for it.

Speaker 2:

Oh yeah, I mean, one of the most sweet and exciting and surprising things that we learned when we were chatting with apprentices was this appetite for stickers and stickers on their hard hats. And you know, I can look out my window and I see three different construction sites just here on my street alone, and I've been watching and I see the stickers. It's nothing I had noticed before, but there's stickers all over people's helmets, and so we've really taken that to heart and had a great time with it, and so if any of your listeners, james, want some level up stickers, we have a whole bunch.

Speaker 2:

I hope they get in touch with me. I would totally send those far and wide.

Speaker 1:

That would be pretty cool. So there's one last point before we send out the stickers, and I just want to get your idea on this. There was a note here of the unfortunate politicization of the substance abuse and dangerous stigmas it carries. So what has gone on here in your opinion sort of macro level, you know from the political side, like and is it also provincial or federal? Like what's happened in your opinion?

Speaker 2:

So truly. I think it's really unfortunate that this issue has become so politicized, because it detracts from the work that needs to be done and it totally casts doubt on all of the amazing work being done by tons of industry stakeholders themselves, but also community service providers. People are grinding and I think that the fact that this issue is so politicized actually speaks to that broader lack of understanding about barriers discussing this issue.

Speaker 1:

So politicized in terms of what? So when you say politicized, do you mean?

Speaker 2:

left versus right kind of thing. Sorry, say that again, do you?

Speaker 1:

mean sort of left versus right mindsets, or when you say politicized.

Speaker 2:

I see it more so, and maybe it could be deduced to that, but I see it more so as policy decisions that are data-driven are the right way to go, and unfortunately, what seems to be happening is that some of the recent decisions in BC, in Ontario, have not reflected the latest evidence. And so you know, we talk about stigma, we talk about barriers imposed by stigma in the workplace, generating these narratives at that political level and then making decisions about the future of support services, for this really worsening issue seemingly does not reflect what the evidence is telling us at all.

Speaker 2:

And so I worry about it. I worry that it's speaking to an ideology instead of speaking to data and evidence of success.

Speaker 1:

I see, okay, that makes sense. So you're hoping for something to be more of a bipartisan thing and it sort of doesn't get into the yeah, yeah, yeah, that makes sense. I mean, I think there's something that happened in BC related to this topic. There's a well-known in the next couple of days who's going to be the new premier of BC, right, because that actually happens on Saturday tomorrow, oh wow.

Speaker 2:

Yeah, oh gosh, I know Big day for you guys.

Speaker 1:

It is a big day. So essentially what happened was the conservatives came and said, okay, well, we've got to help this, and this is specifically on opioid use in downtown Eastside. They got to deal with this because it's just totally out of hand. You drive through there, you will not believe it. Honestly Crazy, anyway. So what they said that they were going to do is they were going to have mandatory care and then the NDP as a last-ditch effort to try and appease and fix that that's what they implemented within like a month.

Speaker 1:

So the first one was a political promise and the other one turned into a reality from the opposition immediately, which which essentially meant that if somebody is at risk to themselves or someone else, they can be picked up which I don't even know how that even works from the Canadian human rights. I don't even know how that works. I mean, can you? I don't know, unless they've broken a law Like I don't know.

Speaker 2:

It doesn't seem in line with BC's former leadership in this topic area.

Speaker 1:

I know, but that's what they just did.

Speaker 2:

I know.

Speaker 1:

It's crazy, so anyway. So we'll see how it all pans out. But I think you know that we did talk about first principles and what I do always find is that when you peel back the onion multiple layers most of us not so much you, because you're in it and I'm kind of in it we peel back a lot of layers, right, but the general public, they're kind of like yeah, peel off a layer here and there, I don't want to talk about it and stick the onion away, right, but you and I keep peeling all the way to the core. The crazy thing is the onion gets less smelly in the middle, it gets more and it's right in the middle. You're like, okay, we can deal with this.

Speaker 1:

But the first principles, you know, I listened to a lot of podcasts and a lot of smart people and they all talk about first principles. Because what it does is it gets you to this baseline of pure pieces that they might be the ugly truth, but at least you know them, they've been discussed and they have been booted around, kicked around and everyone can kind of go okay, that is a really ugly bottom line baseline and we can't be operating at this level. We have to basically build back on this so that that baseline changes and it's basically factor-based thinking and it seems like you have that exact approach and I think that that's what's going to be powerful for you and your organization is the thinking of first principles and how to attack these from a place of truth, statistics, et cetera.

Speaker 2:

Totally, totally, and we hope very much so, to take a lens of empathy and a lens of stigma deconstruction and challenge popular narratives that we've heard and continue to create additional barriers for the folks we're trying to support.

Speaker 1:

Although and I've sort of heard this anecdotally multiple, multiple times I did a little bit of research on it a couple of years ago. But in terms of Portugal and their drug policies, I did.

Speaker 2:

anecdotally, I was actually there earlier and heard a little bit about it, but haven't sunk my teeth into it.

Speaker 1:

So one of the comments I made earlier is that everything that we see out there is a symptom of our culture, is that everything that we see out there is a symptom of our culture. And there they've decriminalized drugs but they have extremely strict policies. Like you can't be whacked out walking around the streets there you get picked up, but you can go and get anything you want, but it's very strict. So I think the main thing that I think you know in in bc they try to, you know, decriminalize everything and that would be fine, but you have to have the strict policies to go along with it, otherwise it turns into just a mayhem of dysfunction, because I mean drug use typically is dysfunctional sure, I mean, decriminalization is not the same thing as having substances widely available.

Speaker 2:

They're different, right? Yeah, decriminalization doesn't lead to dispensaries necessarily, yeah, but it does remove lots of harmful barriers. And there are some brilliant organizations calling for the decriminalization of drugs in Canada. Mom, stop the Harm being a huge one, data insights and share them more widely on in large numbers yeah maybe that can support some of these brilliant grassroots organizations efforts in advocating for some of the policy reforms they want to see yeah, yeah, it'd be, it would be great for so I think a lot of people are just not on the same page.

Speaker 1:

I think that's the main issue. You know, if, if there were um, laws, bylaws and that and everything was sort of dovetailed in for success, because it just seems like it's not that way. It's like, you know, we do one thing and then, when it goes completely crazy, the police aren't allowed to do anything. It's like, well, what do you think was going to happen? It's like, well, what do you think was going to happen? I guess what I'm saying is everyone needs to work together in order to make it work. It's kind of like what you're saying GC're, and it can really all come down to a communication strategy with you guys on. Maybe it's the GC talking to the subs and having their program and asking them, as part of their on the bidding process, what are your programs for drug addiction, for mental health, suicide prevention, what programs do you have? And that's a tick box as you're applying to get the work. Totally, absolutely there's lots of-.

Speaker 2:

Embedding things structurally in. So that-.

Speaker 1:

Yeah, and then I think that to advocate in Ottawa that it would be money well spent and I don't think the taxpayer would have a problem paying for that. They'd have no problem for it. They'd have no problem saying look, you know, we're building. This is one of the largest industries in Canada and we want to make sure we have a healthy workforce that is productive, because we're 60% as productive as Americans, apparently. It's like okay well, why?

Speaker 1:

Why is this so? Yeah, we need to be globally competitive, and no one ever talks about this. Everyone talks about how we're going to fix all these people and everyone's like, okay, well, actually, how do we beat all these other countries that I'm really worried about? Well, actually, how do we beat all these other countries that I'm really worried about? We're going to lose here if we don't actually get our act together and start being that 100% as effective as other countries are, yeah, and I think productivity starts with a healthy workforce.

Speaker 1:

Exactly. See. Now, when we look at, how do we get there? It's like, look, we can't have people who are not supported on the job site, okay, so how do we get to? It's like, look, we can't have people who are not supported on the job site, okay, so how do we get to there? Okay, well, government of Canada, this is what we need. We need these programs. So, when these are in here and they're part of the stack of when people get jobs, the bidding process, have you enrolled in this Health Canada thing for substance abuse? If you haven't, well, you can't work on this job.

Speaker 1:

But they need to get a tax break for doing it. If they get a tax break for doing it, all of this will work.

Speaker 2:

Well, at the very least, Health Canada is putting their resource into developing prevention-based interventions. Our project is just one of many right, so they care. This issue is super important and it's about integrating lots of different angles in the pursuit of how we can support workplaces to support their workers best.

Speaker 1:

Yeah, yeah. Well, that's cool. Okay, I think we should do the sticker thing. I'm also going to be at the building show in Toronto doing a speaker series. I got three guests on stage. Oh cool. Yeah, so if you're there, maybe we can chat again.

Speaker 2:

I would love that, James. When is that?

Speaker 1:

It's in December, okay, yeah, yeah, I'll be there, tatiana, we'll reach out to you and maybe we can meet up or something That'd be great.

Speaker 2:

That'd be great. I've really enjoyed this. I have too.

Speaker 1:

You're very intelligent and a cerebral thinker. So thank you very much. I really appreciate you going toe-to-toe with me on this stuff and I think we're on the same page going toe-to-toe with me on this stuff and I think we're on the same page.

Speaker 2:

I think so too. I've enjoyed it a lot and I've appreciated your views and I've appreciated sharing mine, and I'd love to talk about it more.

Speaker 1:

Okay, great Well, thanks very much. Thanks so much, James.

Speaker 1:

Well, that does it for another episode of the Site Visit. Thank you for listening. Be sure to stay connected with us by following our social accounts on Instagram and YouTube. You can also sign up for our monthly newsletter at sitemaxsystemscom slash the site visit, where you'll get industry insights, pro tips and everything you need to know about the site visit podcast and sitemax, the job site and construction management tool of choice for thousands of contractors in North America and beyond. Sitemax is also the engine that powers this podcast. All right, let's get back to building.