BC Workers are Being Forced Into Mandatory Drug Testing and Private ‘Recovery’ Programs
“I have to do substance testing – 58 tests over two years”
Workers in British Columbia who seek help with substance related challenges say they were forced into an archaic system of mandated abstinence-only treatment and costly monitoring agreements in order to keep their jobs.
The intricate web of connections related to BC’s recovery industry evidently extends to the doctors responsible for assessing workers with substance use problems, and referring them to private treatment facilities.
Many of these facilities charge tens of thousands for a bed and generally operate on abstinence based-principles.
According to Jonathan Chapnick, a lawyer with Portage Legal Services, when an employer becomes aware that a worker may be using substances, they get referred to private addictions doctors called Independent Medical Examiners (IME doctors), even if they have never been impaired at work.
“I’ve been involved in cases dealing with substance use issues in the workplace, and employees being sent home or not permitted to work if they have substance use issues, even if that issue hasn’t shown up at work at all,” Chapnick told PressProgress. “And then, being required to submit to a medical assessment by someone who’s not their doctor, and who they don’t know.”
Kevin, a BC government warehouse worker whose name has been changed to protect his identity, says he is an alcoholic who was working with his doctor to help him quit drinking when he had a relapse and needed to take some time off work.
His doctor wrote “alcohol use disorder” on his doctor’s certificate form, after which he was forced into the private recovery system despite never having been impaired at work.
“I can verify this with several supervisors from work, I’ve had no history of intoxication on the job, none whatsoever,” Kevin told PressProgress.
“It was something I did in my private life.”
Chapnick adds that IME’s, who are physicians chosen by the employer and not the employee, are supposed to be used as a “last resort.”
“In practice, however, many public and private sector employers, and many professional regulatory bodies and insurance providers, will require an employee to submit to a so-called IME in the first instance upon suspecting that the employee is a drug user.”
Some IME doctors from BC, some of which had previously been the subject of conflict of interest complaints, spoke at the 2023 Alberta Recovery Conference about “Recovery Oriented Systems of Care in the Doctor’s Office.”
“There’s a lot of those doctors, those IME doctors who have a financial interest in the rehab industry and then are advocating in BC and Alberta for this kind of recovery approach, anti-harm reduction and trying to get people into these recovery centers,” Byron Wood of Workers for Ethical Substance Use Policy told PressProgress.
Wood says the recovery system for workers in BC is also privatized.
“You’re forced to get an assessment with an addiction doctor who works privately and charges like $3,000 per assessment,” Wood explained. “Then, they own private monitoring companies which you’re forced to go to, which costs a ton of money. And you’re forced to go to a private treatment center, which costs a ton of money.”
Kevin says he was assigned a doctor who had no knowledge of his prior situation, and his usual doctor wasn’t consulted in regards to his treatment plan.
“My doctor and any other health care providers I had at the time had no say in my treatment—absolutely zero,” Kevin said.
BC IME doctors Dr. Jennifer Melamed, Dr. Eithne Marie Durnin-Goodman and Dr. Robert Nelson Baker were previously the subject of conflict-of-interest complaints related to their involvement with addiction clinics or private monitoring companies where their patients were referred to.
Melamed and Durnin-Goodman are both on the Board for Precision Medical Monitoring.
Dr. Melamed also did a presentation for the Alberta Select Special Committee to Examine Safe Supply and argued against safe supply. She also spoke at the Alberta Recovery Conference in 2023 and 2019.
Dr. Durnin-Goodman also did a presentation for the Alberta Select Special Committee to Examine Safe Supply and argued against safe supply and argued for directing funding away from harm reduction and towards “recovery.”
Durnin-Goodman, Melamed, and Baker were not found guilty of wrongdoing or conflict of interest by the College of Physicians .
“Their monitoring companies charge about $1,000 per month and the private rehab centres workers are forced to go to charge about $30,000 for a four week stay,” said Wood.
Wood adds that normally when a person sees a doctor, they can choose whether or not to follow the doctor’s advice.
“However in the context of an IME, the patient is required by their employer to follow the advice of the physician,” Wood said. “This typically includes prohibiting patients from using OAT, putting them at risk of fatal overdose, and requiring them to submit to non-evidence based, ethically questionable and expensive corporatized abstinence based 12-step rehab and drug testing/private monitoring regimes.”
Although he found rehab helpful because he was already trying to quit drinking, Kevin added he didn’t agree entirely with the 12-step model.
“The entire structure of AA is entirely shame based, things like harm reduction are just off the table,” Kevin said.
Kevin said his rigorous testing regime also impacted his ability to work certain shifts and forced him to take on many costs out of pocket.
“I’m on a two year contract now where I have to do substance testing—58 tests over two years.”
“I’m out $12,000 because of being on disability for so long and having to pay for part of the treatment, to pay back my employer for that.”
Chapnick says the design of workplace drug policy is currently designed often causes workers to get funneled into the private system without many other options.
“Often the cases that I was dealing with, they didn’t involve any problems in the workplace. It was just an employee who, one way or another, their substance use issue came to the knowledge of their boss and the process went from there,” Chapnick said.
“They (get) sucked into this assessment, treatment, drug testing vortex that they probably shouldn’t have gotten sucked into.”
Kevin says forced treatment and monitoring has caused him a lot of stress, and that he believes the onerous system is intended to cause workers to lose their jobs.
“It just took so much time and energy out of my life. So it was just awful to not find it beneficial and still be required to do something like that in order to maintain your work,” Kevin said.
“Probably the most common trigger for substance use is stress and anxiety. So in a weird way, this gives them the outcome they want—by getting rid of you.”
Wood, who was fired from his job as a nurse for refusing to undergo private treatment and monitoring, says that this system grossly violates worker’s rights.
“I was fired from my job as a nurse for refusing to continue following my monitoring agreement. I had never been impaired at work and there had never been concerns about my job performance or behaviour,” said Wood.
“My employer should not intrude into my private life and mandate 24/7 abstinence as this is unrelated to workplace safety. So I wasn’t willing to continue submitting to the drug testing.”
Wood says that there are many things that can be done to remedy this.
“In BC, they’ve allowed this part of healthcare to be privatized and unregulated and then they continue to fund it,” he said.
“Unions need to be lobbying the government to regulate drugs, and to regulate treatment centers. And then they need to be troubleshooting with employers to implement workplace drug policies that are actually helpful like providing, you know, voluntary confidential harm reduction services, rather than coercing workers into these harmful kinds of programs.”
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