Michael Kessel has been a funeral director in Toronto’s east end for 36 years, but nothing prepared him for the devastating impact of Canada’s opioid crisis. “I didn’t get into the funeral business [expecting] to be providing services for people who haven’t even reached the age of 25, people who go out one day and just don’t come home.”
Public librarians find themselves resuscitating patrons who have suffered fentanyl overdoses in their branches. Educators routinely scan their playgrounds for discarded needles. Family-services workers have seen a steep increase in the number of children coming into care because of their parents’ opioid use.
The Canadian Union of Public Employees found in a recent survey of its members that, as the opioid crisis worsens, its impact is being felt by employees who have not traditionally been viewed as first responders and emergency workers. “And as members take on roles that fall outside their original job descriptions, the front lines are shifting,” CUPE researcher Amanda Vyce wrote in a special report on the workplace impact of opioid abuse.
“CUPE has more than 300,000 members [in non-emergency occupations] who, because they work with the public in public spaces, regularly encounter or are likely to encounter opioid-related issues on the job that affect them personally and professionally,” she wrote. The additional demands and pressures placed on these workers, who are taking on roles well beyond what they originally trained for, have “left many CUPE members feeling stretched thin and without the supports they need.”
Mr. Kessel is now raising community awareness about the lethal nature of fentanyl and looking into ways his funeral home might better support the shattered family members when the death is drug-related. One recent incident in particular, the accidental overdose of a pregnant young woman, “just broke my heart and I had to step out of the office twice that day to compose myself,” Mr. Kessel said. By that point, he had arranged funeral services for 37 overdose victims in the span of three years.
With the backing of Service Corporation International, better known as Dignity Memorial, Mr. Kessel organized a public forum at a nearby church in mid-September for anyone who wanted to attend. Several of his colleagues were in the room, along with recovering addicts, people who had lost family members to drug abuse, social workers and teenagers who saw the meeting notice and walked in.
A drug-squad officer told the audience that fentanyl is 100 times more potent than morphine and is often combined in a toxic mix with other street drugs. “You are rolling the dice every time you use it.”
In Aldergrove, B.C., a community east of Vancouver, funeral director John Romeyn of Alternatives Funeral & Cremation Services feels a social responsibility to warn children and young teenagers about the dangers before they are even tempted to experiment with drugs. His funeral home sees between six and 10 overdose deaths a month, mostly youth and young adults. He will never shake the memory of the father who told him that he and his daughter had made plans to buy her graduation dress. Instead he ended up buying a dress for her to wear in her casket after she overdosed.
Librarian Terrill Budd, who works at a large branch in downtown Calgary, related that some of her colleagues had found “an unresponsive woman” in a washroom shortly before closing time one day and performed cardiopulmonary resuscitation until paramedics arrived.
While library workers would much rather be providing research assistance, bringing in guest authors and inspiring children to read, “we have people picking up needles in front of some of the branches daily, cleaning out the needle boxes inside the branches and [sometimes] the front-line staff and our security staff dealing with overdoses,” Ms. Budd, who is also chief steward with CUPE, said in an interview.
"It can be challenging and stressful. Library workers care and want to help, but that's not something we are actually trained to manage." After considerable discussion, her branch decided not to equip library workers with naloxone, a drug that can temporarily stop the effects of opioid drugs, because there are security guards on site who are equipped to do that. But, Ms. Budd said, colleagues in some of the smaller branches have asked for training on how to administer the antidote.
The Canadian Centre for Occupational Health and Safety has now issued guidelines for organizations that decide to stock naloxone. Staff should have first-aid training and know how to recognize the signs of an opioid overdose. “Training in how to respond to a potentially violent person is also necessary [because] the person given naloxone may experience acute opioid withdrawal, leading to pain, distress and agitation.” Employers should also recognize that asking employees to treat someone who has overdosed can be traumatic, the federal agency said.
Mr. Kessel and his colleagues have all been trained in the administration of naloxone – in case they have the opportunity to save someone’s life rather than plan his or her funeral.