Let’s Talk — about substance use disorder

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Rita Notarandrea is CEO of the Canadian Centre on Substance Use and Addiction and a member of Clerk’s Contact Group on Mental Health.

What is a first step employees can take when struggling with a substance use disorder?

Do what you would do if you were struggling with any chronic disease. Substance use disorder is a health condition like any other. If we can start talking about it that way, it might make it easier for individuals or families to take the necessary first step to visit a doctor.

Why does this matter to you personally?

Stigma is one the biggest barriers to people seeking and getting treatment. And yet we are all touched by this in one way or another. Your family member, your neighbor, or your co-worker. One in 10 suffer from some kind of substance use disorder. It affects all walks of life. We want to make sure that people know it is treatable. You are not alone. Do not suffer alone.

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How can individuals understand what is healthy versus addictive behaviour?

Without getting into the clinical lingo, ask yourself: “what are the harms this is creating in your life, in your family, in your relationships and with your health? Is the substance seeking behavior taking you away from all the things you used to enjoy like being with family and friends? Is it taking over your life?” That is a personal way of assessing it. But there are clinical ways to assess a substance use disorder so talk to your health professional [Finding Quality Addiction Care in Canada].

What is one thing that may surprise people?

We have done a great job in opening up the dialogue and learning more about stigma and mental illness. But the stigma surrounding a substance use disorder is much greater. Research shows that people hold more negative attitudes towards people with substance use disorder than mental illness.

How important are the words we use to talk about substance use issues?

If someone has an eating disorder — we don’t ever call those people food abusers. Yet for substance use disorder, we think it is ok to use phrases like ‘drug abuser’. There is a lack of information as to what this is all about — the person’s vulnerabilities, their life experiences, how the brain is affected and genetics — these all play a role and contribute to this health condition.

Many will say: “If you love me, you would stop this behaviour”, but that doesn’t work. The more you believe the person has control and is to blame — the greater the prejudice and discrimination. The less you believe they have control and it is their fault — the greater the compassion. Which is why greater education and awareness about this condition is so critical.

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How do you recommend a manager start a conversation with an employee they think is struggling? Many address it as a performance management issue — is that the right approach?

I would say: I’ve been noticing some changes — are you ok? You don’t seem yourself. I’ve been seeing you spend more time alone or snap at people a little bit more than usual– it’s just not your normal behaviour so I’m checking in to see if everything is ok.

If I approached you that way — you’re not going to take it as a work performance issue. You would take it as ‘I am concerned about you’. The employee may wish to say nothing and that is perfectly fine.

It’s important to note, that if there is a safety issue (like a person is working in a safety sensitive job such as an air traffic controller or a driver), and performance is affected, how you approach that discussion is a bit different. But, in general, I would approach it as concern for the employee like you would if there was any other health condition involved.

What is one message you want people to retain?

People attain recovery and sustain recovery. You are not alone. Talk to your family. Talk to people you are close to. Seek help. Because treatment works. People do recover. There is hope.

For more information, visit the Canadian Centre on Substance Use and Addiction website.

Another resource for where can employees can go for help (for themselves or someone they know is struggling) is the CCSA Addiction Care in Canada Treatment Guide.

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