Sam Stahnke in Campbell River, B.C. A knee injury forced him to go on opioid painkillers.CHAD HIPOLITO/Photography by Chad Hipolito/The Globe and Mail
Sam Stahnke had it made. A skilled electrician, he was pulling down $150,000 a year working three weeks a month in the Alberta oil sands. He lived in a big house north of his hometown of Campbell River, on Vancouver Island.
Then a knee injury forced him to go on opioid painkillers. He liked how they made him feel. Soon, he was taking them by the handful, not even stopping to count. He bought a stash of 50,000 pills from a drug dealer: 30,000 Oxycontin, 10,000 Dilaudid and 10,000 morphine. He put the tablets into some extra-big vitamin bottles, packed them in his bag and took them on the plane to Alberta.
He sold some and used the rest. Within a year, they were gone. He got more. He started crushing the pills into powder, mixing it with saline solution and injecting the liquid with a big syringe. Then he turned to heroin, a much more powerful high. He was using an “eight ball” (an eighth of an ounce) every couple of days. It cost him $300 a day, but with the money he was earning in Alberta, he could afford it. He was “young and rich and working in the oil patch and an idiot.”
In all that time, he never missed a cellphone payment. He kept working. He told no one – not his family, not his workmates and certainly not his bosses.
The opioid overdose crisis that has swept across the country is taking a terrible toll on working men. In British Columbia, the Coroners Service found that the majority of those who succumbed to overdoses lived and died in private residences, and had used their drugs alone. Eighty-one per cent were men. Of those who were employed, 55 per cent worked in transport or the trades.
An Ontario study published this past June found that one-third of those who died and had known employment status were in construction. Even among those who were out of work when they died – about half the total – construction had been the most common occupation. In Alberta, 77 per cent who died in 2017 were men. Fifty-three per cent of those whose occupation could be determined were in trades, transportation and equipment operation. Another 8 per cent worked in natural resources and agriculture.
Authorities have been aware of the problem for years. Yet government, industry and unions have been slow to act. Despite recent attempts to tackle it with brochures on workplace bulletin boards and ad campaigns aimed at breaking the stigma around drug addiction, overdose death among working men remains a hidden corner of the opioid crisis, shrouded in shame and silence.
“This has been a neglected population that nobody is talking about,” says Andrea Furlan, a scientist at the Institute for Work and Health in Toronto. “If you ask the average person what sort of people are dying in the opioids crisis, “I don’t think they are going to say, ‘Oh, it’s a 35-year-old male who is working hard five days a week, gets home tired and dies in his house.’ ”
The victims of blue-collar overdose do all sorts of jobs. They are truck drivers, they are loggers, they are house framers, they are fishermen. Some get hooked on painkillers after an injury, like Mr. Stahnke did. Some turn to drugs to combat the boredom and isolation they face in remote work camps. Others stay sober in camp, then overdose when they come home and party, their tolerance for drugs eroded by their time away.
Most keep their problem to themselves. Obedient to the working man’s code that tells them never to admit weakness, they often use in secrecy. That puts them in special danger. In an alley or a drug house, at least, someone might find and revive you if you collapse from an overdose. These men often die alone.
A sign warns of a protected salmon habitat on Highway 19 in Campbell River, which bills itself as the 'Salmon Capital of the World.'
Big Mike the logger hangs from a pole in Campbell River. Timber, fishing and shipping are still cornerstones of the community's economy.
Campbell River is a good place to come to understand why.
For more than a century, men have moved to this rugged and beautiful part of the world to log, mine, fish and toil in the mill. The hard, often dangerous work exacts a price, and some turn to alcohol and drugs for relief.
The city of 37,000 sits at the south end of Discovery Passage, a narrow channel along the northeast coast of Vancouver Island famous for its swift currents and rich marine life. Britain’s Captain George Vancouver charted local waters in the 1790s, trading with Indigenous villagers as he travelled. A century later, loggers arrived to harvest giant trees from the shore.
It was a tough life, and when they had a chance to let loose, they grabbed it.
A preacher who visited in 1904 with hopes of saving souls said the only sound on a Sunday was “a sort of subdued roar coming from the saloon, and occasional groans from perhaps 50 or 100 loggers lying around on the grass, in all stages of intoxication,” local historian Jeanette Taylor writes in River City.
B.C.
Campbell River
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THE GLOBE AND MAIL, SOURCE: TILEZEN;
OPENSTREETMAP CONTRIBUTORS; HIU
B.C.
Campbell River
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Island
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Ocean
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65
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BRITISH COLUMBIA
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THE GLOBE AND MAIL, SOURCE: TILEZEN;
OPENSTREETMAP CONTRIBUTORS; HIU
B.C.
Campbell River
Van.
Island
Discovery Passage
Vancouver
Courtenay
N. ISLAND HWY.
Pacific
Ocean
0
65
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BRITISH COLUMBIA
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Campbell River
Quadra
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Lake
19
Beaver
Lodge
Lands
0
2.5
KM
THE GLOBE AND MAIL, SOURCE: TILEZEN; OPENSTREETMAP CONTRIBUTORS; HIU
A logging crew stands on a tree trunk in Jervis Inlet, east of Campbell River, in 1917.Courtesy of Museum at Campbell River/courtesy of Museum at Campbell River
For decades after, Campbell River had a frontier feel. The railway stopped at Courtenay, 50 kilometres to the south. Lonely workers with money in their pockets partied hard. Some locals took to calling Campbell River “scrambled liver,” describing the effects of all the boozing.
By the late 1950s, Ms. Taylor writes, the city had some of the province’s worst rates of heroin addiction. Cocaine came along in the 1970s and 1980s, then another wave of heroin in the nineties that caused a spate of overdoses. In the early 2000s, it was crack cocaine. Now fentanyl is big, and cheap methamphetamine is coming back.
The North Island health district that includes Campbell River has one of the highest per capita rates of death by overdose in British Columbia. It had 38 such deaths in 2017, 20 of them in Campbell River, and 29 in 2018, 13 in Campbell River. As recently as 2014, the district had just four deaths.
In most ways, the city is thriving. House prices have been soaring as retirees flock to Vancouver Island for the great boating and hiking. Anglers come for the whopping “tyee” salmon in the “Salmon Capital of the World.” Tourists come to watch sea lions, humpback whales and orcas. Foodies can grab a lentil-cashew burger at the busy health-food supermarket downtown.
But signs of the drug epidemic aren’t hard to find: yellow needle-drop bins in public washrooms, young people using drugs on forest trails, intoxicated men on downtown sidewalks. One emergency-room doctor says many nurses have quit, fed up with the stress of dealing with so many disorderly, mentally ill and stoned arrivals. Another doctor tells of how a young woman hanged herself after seeing a long-time friend overdose and die before her eyes.
The suffering of working men is less noticeable, but just as real. Mr. Stahnke, the oil sands worker, never stumbled along a downtown street. He used his drugs in the comfort of his wood-beamed home, which he renovated himself. “I had tons of money. I am buying enough to kill 10 elephants at a time. And I’m just doing it alone in my house,” he says, recalling the years before his recovery. “I’m lucky to be alive.”
Mr. Stahnke says Brazilian jiu jitsu has helped him with his recovery from drug addiction.
Dave Johnson of the local RCMP says it’s a common story. One of his jobs is responding to overdose calls. After he was posted to Campbell River two years ago, he was surprised to find himself being summoned not just to shady downtown parking lots but to neat, quiet streets like the one he lives on. In one case, the victim, a man employed in the building trades, had moved in with his parents after his marriage broke up. They had no inkling he was a user until he died.
“When we start getting more reports of sudden deaths of middle-aged aged men, it piques our attention,” Sgt. Johnson says. “You realize these are folks with homes and jobs, and live what appear to be very normal lives.”
At Campbell River’s overdose-prevention site, lots of working guys come in: loggers, fish-farm workers, tugboat crewmen. They come to use their drugs in a safe setting, or to pick up sterile needles and other equipment. Some get their supplies and go right back to work. “If you walked by them, you would never give them a second look,” acting manager Sarah Spindler says. “A lot of our clients have houses and mortgages. Most of their co-workers would have no idea they have been using “
The local sobering centre sees plenty of blue-collar users, too. It offers a safe place to sleep for people who are drunk or high, and might otherwise have spent the night in jail or hospital. One recent night, a middle-aged logger came in. He’d hurt his ribs and spine when he was crushed by a falling log. A doctor took him off his painkillers because he was getting hooked, so he turned to street drugs. He said he was popping 40 to 60 pills a day. Kevin James, who runs the centre, found him sitting on a chair, weeping from frustration.
Twenty minutes later, another man with a similar story checked in. He’d hurt his hip in an industrial accident and got hooked on painkillers. For men like them, drug use has become far riskier in the age of fentanyl, the synthetic opioid many times more potent than heroin. These days, Mr. James says, “it’s like playing Russian roulette at every party.”
Kevin James, co-ordinator of the Vancouver Island Mental Health Society, runs the sobering centre in Campbell River.
Keri-Anne Jerome, a recovered drug user, lost a friend that way a couple of years ago. A faller in a logging camp, he would stay off drugs while at work but party hard when he came home. He overdosed in his mother’s garage. He was in his 30s. She had known him most of her life.
Ms. Jerome worked with a community action team created to look at the sources of the drug problem in Campbell River. In a report released this past spring, it drew a portrait of the typical working user: “These men tend to be Caucasian, to be employed in the trades, earn a good living, and use substances in the privacy of their homes. Their substance use is not often visible, and these are people whom society generally does not associate with the opioid epidemic.”
The city’s history of isolation, resource extraction, boom-and-bust economic cycles and trauma for its Indigenous people all play a part in the drug problem, says the report, which relied on interviews and focus groups. It found that 80 per cent of those who died were men. That’s a pattern that holds across the country. Nationally, 75 per cent of those who died of overdoses in 2018 were men.
One reason may be the high rate of injury. A Statistics Canada study using 2003 data showed that 9 per cent of workers in transport, trades and equipment operation are hurt at work, more than four times the level for those in less strenuous jobs. The B.C. Coroners Service found that 45 per cent of the fatal-overdose victims it studied had sought help for physical pain in the year before they died.
A defunct surge tower stands at the John Hart Generating Station in Campbell River. The closing of a local pulp and paper mill and mines have darkened the region's economy.
Fly fishing in Campbell River. Some in B.C.'s North Island make their living through salmon farming, though during the federal election, the Liberals promised new limits on open-net aquaculture that have left the industry's future unclear.
Before the overdose crisis exposed the dangers of addictive painkillers, doctors often handed out pain pills liberally to injured working men. Changes to prescribing guidelines in 2017 led doctors to reduce dosages. When the workers couldn’t get enough or their worried doctors cut them off, many went to the street for their pills. That put them at risk of using tainted drugs that might cause a fatal overdose.
British Columbia’s Fraser Health Authority found that 70 per cent of fatal overdoses in the district west of Vancouver occurred in private residences and 85 per cent of the victims were men. About a third were working or had recently worked in construction.
The building trades employ 200,000 workers in British Columbia. Nine out of 10 of them are men. And men often won’t seek professional help for their pain or mental distress, turning to drugs instead. So some are overdosing and dying. Average life expectancy is falling in several Canadian provinces, particularly for men: It fell by 0.28 years for men in British Columbia from 2016 to 2017, compared with 0.05 years for women. Men of working age are by far the most likely to die of overdose. The Coroners Service found that of the deaths it studied from 2016 and 2017, 193 victims between the ages of 30 and 39 were men; just 40 were women.
The problem is compounded in places such as Campbell River, where 22 per cent of workers are employed in resources, construction and trades, compared with 12 per cent in British Columbia as a whole. Eighty-five per cent of those workers are men.
Many local jobs have disappeared. The Elk Falls pulp and paper mill closed in 2010, and many mines have shut down. A big forestry strike has idled workers for months. So guys often have to travel to other places, such as northern B.C. and Alberta, for jobs. Some go as far as a diamond mine in the Northwest Territories or a gold mine in the Dominican Republic. In fact, 11 per cent of workers labour outside the community – double the provincial rate. That makes it harder for them to get consistent medical care or stick to an addiction-recovery program.
It can also put a strain on their personal lives, triggering depression or anxiety that can lead them into drug use. “Maybe your camp life is ruining your marriage. Maybe your kids don’t talk to you anymore,” says Kelsi Baine, who runs a Campbell River service that offers counselling to locals. “Maybe your wife is mad at you because you’re never around, and when you are, you’re just sitting around playing video games.”
The working man’s code makes it hard for them to seek counselling in the first place. "The trades have not been an easy place for people to stick up their hands and say, ‘You know what? I’m struggling. I have issues with fentanyl, I have issues with alcohol,’ ” says Erika Kellerhals, a local doctor who treats patients for addiction. “I think there has been a real sort of mentality of, like, ‘Suck it up, buttercup.’ Just: ‘Hush hush.’ ”
Treating drug addiction is part of Dr. Erika Kellerhals's practice at the North Island Medical Clinic.
Her patient Mr. Stahnke says shame and fear of getting fired kept him from seeking help for years. The son of a teacher and a civil servant, he simply could not bring himself to admit he had become a user. “People like me from normal families can’t go stand in line at methadone clinics,” he says.
British Columbia’s Minister of Mental Health and Addictions, Judy Darcy, says working men have been made to feel addiction will be “treated as a sign of weakness or a moral failure, so you’re probably less likely to reach out for help.”
Tom Sigurdson, former executive director and current advisor with the B.C Building Trades Council, says that “a lot of people out there say, ‘I can handle it,’ and when they can’t, they don’t want to admit it.” When a workmate overdoses, a common response is: “Poor old Chuck just couldn’t deal with it.” He says that among 25 unions in the council, every single one has seen a member succumb to “that fatal last dose.”
Authorities say they aren’t ignoring the problem of working men and opioids. They say they’re talking more about drugs at workplace-safety sessions, helping get workers into treatment and making it easier to get them back to work once they’re better.
WorkSafeBC, the agency in charge of on-the-job safety, reports that the number of workers prescribed high levels of opioids fell by half from 2015 to 2018. It’s helping injured workers find better ways to manage their pain. But those who work in the field say it’s not nearly enough. “Until we start showing people that their organizations are not going to penalize them for coming forward, they’re not going to,” addiction specialist Colleen Salter says. If you think you might be fired, she says, "you’re going to hide it as long as you can.”
To get the message out, she goes to resource companies in the Campbell River area to give talks about addiction and how to get help. One local forestry firm, Strategic Natural Resource Consultants, was happy to have her in. “Getting people to report without being afraid of losing their job is a really big thing,” company official Jake Bapty says.
Others are too small or too busy too bother. In British Columbia, 90 per cent of construction firms have 10 employees or fewer. Without human-resources staff or employee-assistance plans, they often lack the capacity to deal with the issue. And construction workers tend to be footloose, bouncing from one job to another.
When the Vancouver Island Construction Association holds education and training sessions on the drug issue, it often gets as few as two or three people showing up. Most employers are more interested in how to cope with discarded needles or intoxicated people who come to their work sites than on opioid use among their own workers. Association head Rory Kulmala says that not one of the 450-member companies from up and down the Island has come to him to say they have an opioid problem.
Unions, too, seem wary of addressing it. “I hate to say it, but I think they are kind of shy about getting involved,” says addictions worker Ben Olsson, secretary of the Campbell River, Courtenay and District Labour Council. He would like to see more workplace training on how to deal with mental-health issues and addictions. “Why are we afraid to talk about it? What are we hiding and denying?”
Authorities admit they don’t even have the information they need to understand the scope of the problem. Nearly four years after British Columbia’s health officer declared a public-health emergency because of soaring overdose deaths, a communications officer with the Addictions ministry could not find a single detailed study of working men and opioids beyond that survey of deaths by the Coroners Service. Unlike their counterparts in the United States, Canadian authorities don’t know how many workers are overdosing on the job, how many hours those workers are missing because of opioid problems or how many employers report they have been affected by opioid use among their workers.
It took an Edmonton grad student to come up with some numbers. Alexander Cheung started asking questions about the opioid crisis after working as a volunteer at a breakfast program for needy people in Nanaimo, a city down the Island from Campbell River that has been hard hit by the crisis. He learned that most overdose victims were employed. As an economics student, he wondered what the early deaths of so many working people was costing the Canadian economy. Looking up the the average age of retirement in Canada and the average age of victims when they died (42), he plugged the numbers into a research model developed by the U.S. Centers for Disease Control and Prevention, and came up with a startling figure: $4.73-billion in lost labour productivity since 2016.
Data like that are hard to come by. So are the resources, such as treatment and rehab programs, to deal with the impact of the crisis on working men. In Campbell River, officials and local doctors are frustrated. Asked whether she had enough resources to deal with the opioid crisis, Charmaine Enns, Medical Health Officer for North Vancouver Island, says simply, “No,” then repeats, “No.”
With so many people using drugs on their own, in silence, out of range of help, it’s tough to make a dent in the problem. When you don’t know who the users are, Ms. Enns says, “How do you respond? How do you intervene?”
Boats are docked near Tyee Spit in Campbell River. The waters around the town of 37,000 were charted by British explorer George Vancouver in the 1790s.
The Big Rock sits along the shore in Campbell River. Borne to the shore during the last ice age, it became a subject of First Nations legend and today is a local tourism attraction.
Mr. Stahnke finally hit bottom a few years ago, when he spilled a $1,500 bag of heroin and found himself sweeping it off the dirty floor of his house to use. That’s when he knew it was time to seek help. “Once you get to that point, it’s not like you enjoy it,” he says. “You’re only ever thinking about two things: how badly you need to get high and, as soon as you get high, how much you hate yourself for what you just did.”
He told his shocked parents about his addiction. He told his family doctor, breaking down as he admitted his secret. He tried to quit cold turkey, but like so many before him, relapsed and started using again.
He ended up in Dr. Kellerhals’s office. She put him on suboxone, a substitute opioid that reduces the craving for drugs without producing a high. That was coming up on three years ago. He says he has been fine since. He takes two suboxone pills in the morning, letting them dissolve under his tongue. He is sharp and fit. Jiu jitsu sessions help keep him in shape.
Mr. Stahnke is 35 years old now. He still travels to northern Alberta for work and still makes good money – enough to get him a new, fully loaded black pickup that has pride of place on his Facebook page.
He hopes that telling his story will encourage others in his position to get help. But he still hasn’t told his employer anything.
Mr. Stahnke throws the ball for Boomer at the Tyee Spit.
Editor’s note: Tom Sigurdson is now in an advisory capacity with the BC Building Trades. This version has been updated.
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Marcus Gee