Like the U.S., Canada is struggling to contain an opioid epidemic that has led to thousands of deaths from overdoses and thousands of people struggling with addiction and finding treatment. Opioid-related deaths from 2017 are still being tabulated, but the Public Health Agency of Canada expects the final number will be record breaking at over 4,000. That’s considerably higher than the 2,946 lives lost to opioids in 2016.

For those struggling with addiction, finding and getting into treatment is essential. Last month’s issue of Lifelines examined how to choose a quality rehab facility in the U.S., and many of those factors also apply in Canada. However, differences in health care coverage among the various provinces can create additional challenges for getting help. Furthermore, there are no mandatory regulations or provincial standards for opioid treatment. The fact that there is no standard treatment can present a serious problem for construction workers, who are prescribed opioids to treat wear and tear injuries and chronic pain and are at high risk for dependency and addiction. Fortunately, LIUNA District Councils, Local Unions and Health and Welfare funds are taking steps to help ensure members in need of treatment get timely assistance.

Health Care in Canada

Canadian citizens have access to health care coverage through the Canada Health Act, a series of 13 provincial and territorial health plans. These plans cover basic medical treatment, preventive care, physician referral and emergency hospitalization and some government-funded addiction rehab. Just how much funding and the types of treatment available can vary as there are no mandatory regulations or provincial standards. There are also often months-long wait lists. In addition to the other barriers listed above, privately funded programs frequently have shorter or no wait times, but without supplemental insurance, costs must be paid for out of pocket. Provincial health care also doesn’t cover prescription medications. Without a supplemental insurance policy that includes buprenorphine, methadone and other medications used in treating addiction, these drugs must also be paid for out of pocket.

Help from LIUNA

That’s where LIUNA can provide assistance. Medical insurance available to members through their health and welfare funds can help defray costs at both public and private treatment programs and for prescription medications. With legalization of marijuana and related byproducts expected in the next few months, a number of LIUNA benefit plans may move toward including hemp-derived cannabidiol (CBD) as a non-addicting, pain-relieving alternative for doctors to prescribe in place of an opioid. Finally, to reduce the risk of being put on a waiting list, a number of LIUNA Locals, as well as the LIUNA Canadian Tri-Funds are working with specific treatment centers to make sure space for LIUNA members is available when needed.

Other Responses to Canada’s Opioid Crisis

In acknowledgment that some people struggling with addiction are not ready for rehab, some provinces are trying approaches not offered in the U.S. in the hope that doing so will make illicit drug use less dangerous:

• Supervised injection sites that provide sterile syringes to addicts, who inject drugs under the supervision of medical staff, operate in a number of provinces. Proponents say supervised injection sites reduce the risk for overdosing and transmission of diseases, including hepatitis C and HIV that can occur from sharing needles.
• Vending machines that distribute prescription opioids. Using funds from a million dollar Health Canada grant, the B.C. Centre for Disease Control (BCCDC) is installing three vending machines in Vancouver that dispense hydromorphone pills. Before accessing the machine, participants must first consult with an off-site pharmacist through a two-way monitor. The BCCDC expects this will reduce addicts’ dependency on heroin and other street-level drugs that are increasingly being cut with fentanyl, which is 30 to 50 times more potent than heroin alone. In 2017, fentanyl was detected in more than 80 percent of illicit drug overdose deaths in British Columbia.

Additional Resources

The Federal Government of Canada has several resource sites regarding addiction management and safe drug administration sites. Each province also has its own Ministry of Health site with specific resources for addiction and rehabilitation. Much of this information is available in Finding Quality Addiction Care in Canada, a drug and alcohol treatment guide assembled by the Canadian Executive Council on Addiction and the Canadian Centre on Substance Use and Addiction.

For further information email info@ccsa.ca or call 613-235-4048.

The LHSFNA has developed a number of materials to help people struggling with addiction. These include the Opioid Abuse & Addiction and Prescription Drug Addiction Health Alerts and the It’s Your Choice When You Know the Facts about Drugs and Alcohol pamphlet. To order these and other health and safety materials, click on Publications. For more information, call the Fund’s Health Promotion Division at 202-628-5465.

[Janet Lubman Rathner]