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Rural addiction has special challenges

More than half of farmers meet the diagnostic threshold for anxiety and more than a third meet the criteria for depression
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Therapists say substance use and mental health are connected.

WESTERN PRODUCER — “When it started, it was liquid courage. Alcohol works wonders for anxiety — for the first hour.”

So says Gerry Friesen from his home office in Manitoba. With his heavy glasses and warm smile, the former hog farmer, now a stress and conflict management specialist and mediator, has an easy way about him. He’s thoughtful and calm when peering through the Zoom screen. To look at him, you’d never know anxiety has hummed in him for as long as he can remember. For Friesen, alcohol was a solution — until it wasn’t.

“It’s probably fair to say that farmers — folks in agriculture — likely experience higher rates of substance use disorder than the general population,” says Tammy Thielman, a registered social worker and therapist from Salmon Arm, B.C.

“It’s important to know that mental health and substance use … these things are connected.”

Thielman has years of experience in emergency rooms. A former urgent response mental health clinician and a registered social worker at rural hospitals, Thielman, who is now in private practice, would see people in crisis.

“I would meet people when they would come in extreme distress. These were folks who seemed to be managing well. Maybe they were managing their own farm, maybe a couple of farms. They’d hold out and hold out and then they just couldn’t do it anymore.”

The Canadian Mental Health Association reports that more than half of farmers meet the diagnostic threshold for anxiety and a third meet the criteria for depression. In Canada, alcohol is a factor in approximately 25 to 30 percent of completed suicides.

Studies in both Australia and the United States highlight higher-than-average suicide rates for farm workers, and although there are no similar Canadian studies, our risky drinking habits are well-documented.

Canadians drink about 10 litres of pure alcohol per capita a year, about 3.6 litres more than the global average. According to a 2019 report from the Canadian Centre for Substance Use and Addiction, our hardest-drinking provinces are Quebec followed closely by Alberta, British Columbia and Saskatchewan, and in the 2019 Global Drug Survey, we rank third behind the United Kingdom and the United States in “drunk days” with 47. Canadians in rural areas are more likely to report heavy drinking (22.4 percent) than those in urban areas (18.4 percent).

Substance use disorder (SUD) doesn’t start with mickeys tucked behind the tractor seat. It begins somewhere simple and uncomplicated and socially acceptable.

“We normalize quite a high intake,” says Thielman.

“Maybe it’s a wild night at the curling rink or a weekend out at the lake. Then we see folks who are heavy social drinkers — do they meet the standard for alcoholism? Yes, but they don’t have the language.”

Gradually SUD impacts the brain and leads to a progressive inability to control the use of alcohol, drugs, gambling or pornography.

Addiction is defined by a physiological need for the addictive substance and is characterized by tolerance, a progressive requirement for higher doses and well-defined physical and emotional withdrawal symptoms.

“No one is born with the ambition to become an addict,” says Cynthia Beck, a clinical psychology researcher at the University of Regina.

“All addiction is predicated by an issue with mental health. Whether they’re self-medicating or the mental health comes after, no one is an addict because they’re happy. Sometimes we are our own worst enemies.”

For Friesen, his recovery journey began in 2005. Suddenly finding himself with double the work load on his struggling farm, a neighbour dropped in to see how he was doing.

“He just listened. He didn’t offer solutions — he took 45 minutes and he just listened,” says Friesen.

“That was a turning point in my journey. He was my angel that day.”

SUD can fly under the radar, says Thielman.

“It’s what they saw growing up — Dad drank this much at night and now they do, too. It can be hidden — we may not even see our neighbours. There’s a lot of isolation for what they’re using, how they’re using it. And that can make it much more dangerous.”

Long, solitary working days and high levels of anxiety make a potent cocktail.

“It’s so easy when you’re on the farm by yourself,” Friesen says.

“You can be wasted most of the day and no one will ever know.”

There’s also a lack of information about what SUD actually is: how it shows up, why it’s accepted, who is affected and how to support them.

“You have to talk about it,” says Friesen.

“In my work now, I’m amazed at the number of women who’ll call me after a meeting and start talking about these larger issues and not the financial one that initially brought me to her kitchen table.”

Resources available

A variety of resources are available for those dealing with substance use disorder:

In small communities, access to treatment can make next steps difficult.

“I know people who will drive an hour to another community to go to an AA meeting,” says Thielman.

“There’s a higher chance of maintaining anonymity and preserving dignity.”

It’s also important to farming people to find help that looks and sounds the way they do.

“I’ve had folks tell me, and I get it, that they’re not going to go and see someone who works in an office, 9 to 5. That’s not their reality. That credibility piece is huge.”

Friesen agrees.

“You go to a counsellor or a doctor and they tell you you have to take two weeks off. If you’re in the middle of combining or calving, you can’t do that. You want to talk to someone who’s intimately familiar with agriculture.”

While resources are more plentiful for the one struggling with SUD, support for family members can still be difficult to find. Online options and crisis lines can help to fill the gap, but Friesen is firm.

“Don’t stop talking. You have to keep talking. Most of the stuff I know, I learned from talking to other people. You learn. We learn.”