ST. ALBERT, ALTA. -- Marcel Belland was like two different people: he was an outgoing, charming, friendly, fun-loving, kind and gentle man for most of his life. But after his anxiety, depression and addiction to alcohol escalated, he became unhappy, introverted, isolated and hard to reach.

The pain of living became too much to bear and in March 2020 he took his own life.

Jillian Bourgeois, Belland's widow, said she knew deep down he didn't want to be so sick and unwell, but Belland struggled to get the help he needed for his addiction and mental health.

“There is no way the man that I married didn't want to get help,” Bourgeois said.

Bourgeois and Belland met when they were just 18 years old and fell in love. The couple married in 2004 and Belland was healthy and happy until 2013.

Bourgeois first started to see signs of anxiety and depression from her husband after her two sons, Benjamin, 11, and Brody, 9, were born.

Belland struggled to cope with the stress of having two kids and the financial burden on the family after Bourgeois took two maternity leaves back-to-back.

“I started noticing changes that were loss of friendships and increased stress on our marriage,” Bourgeois said.

The changes were small and gradual. Belland had always been a heavy drinker during his life, but Bourgeois didn't think too much of it for most of their time together. Bourgeois had originally chalked it up to the trades culture he was in and coming from a family that drank more regularly than her own. His drinking was also normalized by a group of friends who drank as much as he did.

Now, looking back, she sees 2011 as the beginning of his struggles.

“I noticed changes in his personality, because he was always a very fun-loving, easygoing guy, kind and gentle, and his personality was changing, where he was more ... more introverted, harder to reach, always being alone,” Bourgeois said.

“It's very gradual, and subtle ... until eventually (it reached) the point that it was a change that you couldn't go back from. I couldn't reach him any more.”

Belland started becoming unhappy in his job, and in 2015 switched from being a heavy duty mechanic to working on the sales side of his company, but he found the transition difficult.

Alberta's economy had recently crashed and making a sale was hard. Belland went from a job he was experienced in to becoming a rookie who was struggling to make money.

“It was just a struggle from the get-go,” Bourgeois said.

Belland was also the kind of person who worked well with a structured schedule - having to be at work from 8 a.m. to 5 p.m. - and suddenly his schedule had loosened up and his job was more flexible. He was driving around trying to build relationships and make sales, but Bourgeois said he would start to come home at lunch and have a beer and nobody would know.

The problem was made worse by the wine-and-dine culture of sales, and Belland would regularly take his clients out to dinner and drinks, feeding his growing addiction.

“It's very much the culture of those jobs and that doesn't help for somebody who's susceptible to alcoholism,” Bourgeois said.

His difficulty making sales in a highly competitive field hit his self-esteem, Bourgeois added.

“It also contributed to the depression - just not feeling like you're good enough.”

Bourgeois worked as an appraiser at the time, which was a stressful job as well. The combination of family and work stress drove Belland deeper into his depression and he became more reliant on alcohol.

“I think that it was the combination of (it all) that tipped the scales and he reached a point of no return,” Bourgeois said, adding he was also treating some trauma through his drinking.

By 2016, Belland was no longer working and was spending his days at home drinking. By 2017, his alcoholism had taken over.

“It was textbook - the downward spiral of how it takes over your life and that's when you know that it needs professional help,” Bourgeois said.

The mom struggled to take care of the family financially, while also taking over all of the childcare of their two sons, because Belland was withdrawing and not able to help.

“He was just very angry,” Bourgeois said.

Belland got medication for his depression and anxiety, as well as sleep medication, but that didn't help the situation. The father didn't take the meds properly and would take an extra sleeping pill at 4 a.m. if he couldn't sleep - then would end up sleeping all day.

Eventually, he started living his life at night while the rest of the family was living during the day, and would spend much of his time outside smoking, marking a big increase in his nicotine consumption. His and Bourgeois' daytime interactions became increasingly more volatile, exploding into fights where objects got thrown and items got broken.

“We had to leave, because it wasn't safe any more for me and my boys. It just was not healthy for the boys. He was unpredictable and fights were getting escalating to the point that it just wasn't safe any more,” Bourgeois said.

The mom had to leave her husband with no job and no way to support himself, but she couldn't stay in the house any more.

After 2017, Belland moved in with his mom and went to rehab several times.

“There would be periods of good, like where you can tell that he was good, and then periods where you could just tell that he was drinking again, or not taking the meds at the end,” Bourgeois said.

Ehsan Latif, economics professor at Thompson Rivers University, studied the link between recessions and drinking and smoking habits of Canadians. Latif said during a recession, people are more likely to increase their binge drinking and smoking habits.

Latif found when unemployment rates increase, binge drinking habits - characterized as consuming more than five drinks in a sitting - also increase across the population. Nicotine consumption increases, too, but only for those who are already smokers.

Latif said the 2015 recession didn't create new drinkers in society, because most of the population already drinks.

“It's because of mental stress. They want a way to survive or find some mental relief through drinking,” Latif said.

Smoking can also be a mental relief for those who already have an addiction to nicotine, Latif said.

Another reason people are more likely to drink and smoke is because they lose hope and are less concerned about their health in the future.

“If people become unemployed for a long term of time with no job, then they become so frustrated and ... they aren't concerned about the future outlook - it's not a rosy outlook, so they don't care about the future and what will happen to their health,” Latif explained.

Latif found the results were more pronounced in men, but mostly because past recessions across Canada have impacted men more than women, including mass layoffs in the oil and gas industry in Alberta or the manufacturing industry in Ontario. During the COVID-19 pandemic, by contrast, Latif said women are being impacted more than men so he isn't sure how this current health crisis and economic downturn will impact the smoking and drinking habits of men and women.

The study wasn't specific to those who were unemployed, but looked at overall population rates of drinking and smoking during a recession. Latif said those who are unemployed may have more time to drink and smoke because of being laid off, but those two habits are expensive, and they will have less money to spend on their habits, so it is unlikely that drives the increase in rates.

In 2017, overall substance use cost Canadians almost $46 billion, led to more than 275,000 hospitalizations and contributed to the loss of nearly 75,000 lives.

Alcohol is the most popularly used psychoactive drug used in Canada aside from caffeine, and drinking alcohol was the top risk factor for poor health in people ages 15 to 49 years in 2010.

Increased drinking can result in a wide range of negative impacts on society, including increased rates of premature death, disability and disease, impaired driving, reduced productivity, a burdened health care system and high financial costs to individuals and society.

In 2002, 4,258 deaths in Canada were related to alcohol abuse, representing 1.9 per cent of all deaths. The economic costs associated with alcohol consumption sit at $14.6 billion and an additional $5.9 billion to lost productivity, $4.2 billion to healthcare and $3.2 billion to criminal justice.

In 2011, alcohol-related disorders were the top cause of psychoactive drug hospitalization in Canada and around 78 per cent of the general population aged 15 and over reported alcohol use.

While there is a lot of data on alcohol consumption, Latif said the consumption rates of other drugs are hard to study, because most, excluding cannabis, are illegal and tracking the increase or decrease in market is challenging.

Emma Buhr, a 20-year-old Albertan who works at Costco, said her consumption of cannabis increased since the beginning of the pandemic because of the stress of her job and having to delay her education.

“I think I've smoked weed every day for the past five months,” Buhr told Great West Newspapers.

Research shows cannabis is one of the most commonly used substances in Canada, with 15.6 per cent of all Canadians reporting having used the drug in the past three months.

“This isn't a good use of my money, or it's not a good idea in the long run. But I really can't see how I'm going to spend my days without it,” Buhr said.

Buhr has been smoking weed since she was 16, but she was always able to step away from it and take breaks for weeks at a time.

“But then ever since the pandemic, the thought of me going two days without smoking weed, it just - it frustrates me and I don't think that those days will be easy,” Buhr said.

When the pandemic hit, Buhr's job suddenly became very stressful. The 20-year-old was tasked with ensuring people were social distancing, wearing masks, not bring in their reusable bags and bringing in only two members of their family at a time, all while the public was scared and shoppers were taking out their frustrations on her.

On top of the work stress, Buhr was upset because she had to put her education. As a hands-on learner, she couldn't do online classes.

“I just felt like at the end of every night after work, it was the only way I could go to sleep and I felt almost as if I earned it, because I worked eight hours, putting my health and safety at risk - like the least I owe myself is to unwind,” Buhr said.

When it comes to opioids, a strong link has been found between recessions and an increase of opioid deaths. Research spanning from 1999 to 2014 found when house prices drop, opioid deaths increased significantly. Other research has found links between opioid use and unemployment. Overall consumption of drugs has increased during times of economic recessions, with many authors suggesting the increased psychological distress from heightened unemployment leads people to lean on drugs to cope.

Rolando Hyman, a therapist based out of Fort McMurray who treats addiction, said when times get hard, many people fall back into their old habits to cope with their stress.

“As things become more intense, people tend to fall back into old behaviours,” Hyman said.

People who are in recovery from substance use may be doing OK, but when life starts to get challenging, like losing a job or having financial struggles, they may fall back into their default mode.

“Sometimes it's not choice, but just by circumstance,” Hyman said.

Hyman said those who may be new to recovery, haven't developed a good self-care routine and don't have strong, healthy natural supports in their lives to lean on may be more likely to fall back into their old habits.

Right now, due to the recession and pandemic, Hyman said demand for services has increased and he said he could be treating people every day, all day if possible. At the beginning of the pandemic, the rush for services wasn't as strong, but now that we are eight months in, people are starting to need new coping mechanisms and support.

In Fort McMurray, Hyman said there is also a high demand for services when the economy is booming.

“When things are great, there is more money,” he explained, noting the population in the area may favour drugs that quickly leave the system, like cocaine, so they can go back to work and pass a drug test.

Society has also normalized excessive alcohol and drug use, Hyman said, making unhealthy habits part of regular socialization. The need for people to belong and the fear of missing out may drive people to use more substances than they are comfortable with just to fit in.

When people do reach a harmful and unhealthy level of substance consumption, it can be hard for them to reach out and get help.

“There is a certain amount of pride that goes with it, and sometimes the hardest step of the process for those who struggle with substances is to step forward and say, `I need help,”' Hyman said.

In 2012, 18.1 per cent of Canadians met the criteria for alcohol abuse or dependence at some time in their lives, many of which were in that past year. This number grew to 19 per cent in 2016.

But behind every person struggling with substances is a family struggling to support their loved one.

Lerena Greig, executive director of Parents Empowering Parents, said their evidence-based support program for family members trying to help people coping with addiction is important to keep those families healthy.

“Addiction is a family illness. It impacts not just the parents - it impacts the siblings, it impacts the grandparents, it impacts the caregivers, the aunts and uncles,” Greig said.

“What happens with addiction is if you don't have some knowledge and some education on how to keep yourself healthy, in the midst of supporting your loved one, you can get co-sick. So what happens is the cycle has an opportunity to continue because everybody's getting sick in the midst of it.”

Greig said when the economy is both good and bad, they see an increase in people attending their support groups.

“When things are good, when money is flowing, (the) addiction rate is high. When things are bad and the economy is slow, addiction rates are high,” Greig said.

But Greig said it is more complex than just an economic issue - there are multiple ways to get addicted and there are multiple ways to get into recovery.

“A lot of the basis with addiction is escapism,” Greig said, mainly escapism from pain.

Families can come to the group and learn how to not let their loved ones' addiction take over their life.

“We can educate people on the things that they need to do and put into place right and come back to health. Because you can interfere in their addiction when you're healthy,” Greig said.

But for all those who are reaching out, Greig said other families are feeling shame and are afraid to ask for help. Greig said their internal research found some families visited their website for six months before reaching out and joining the group.

Since COVID-19 started, Greig said they are seeing an increase in their attendance, but Greig said that could be due to becoming more well-known due to an increase in funding and becoming more accessible to people across the province thanks to hosting their meetings online.

For anyone suffering from substance use disorders, Hyman and Greig both said the isolation and cultural disconnection will make it more challenging to stay mentally well and sober.

A Canadian report on the state of public health released this week shows that across the country residents are struggling with mental health and addiction.

While the majority of Canadians over the age of 15 didn't change their substance consumption in the early days of the pandemic, some did report an increase in alcohol (14 per cent), cannabis (6.5 per cent) or tobacco (3.3 per cent) consumption. People between the ages of 15 and 34 were more likely to increase their consumption and those with already poor mental health were more likely to increase their substance use.

People with existing substance use disorders felt an additional strain due to social distancing and limited trips outside of the home, which may have reduced access to services like support groups.

While these restrictions were hard on everyone struggling with substance use disorders, those facing opioid addictions were hit even harder, making the opioid crisis worse across all of Canada.

Before the pandemic, there had been a 13-per-cent decrease in opioid overdose deaths in Canada between 2018 and 2019, particularly in Alberta and British Columbia, but the pandemic has set back that progress with an increase in deaths due to the crisis. One of the reasons opioid poisoning deaths have increased is due to the increasing toxicity of the the illegal drug supply since the start of the pandemic.

While British Columbia has been hit the hardest, Alberta has seen an increase in deaths since the pandemic began. In the first six months of 2020, data shows 449 people have died from an apparent unintentional opioid poisoning.

In the most recent quarter, 284 people have died from an apparent unintentional fentanyl-related poisoning, compared to 130 people in the previous quarter. Alberta saw a significant increase in opioid-related deaths in the three-month period from April to June this year (301 total), up from the previously recorded high of 211 deaths in a three-month period in 2018.

And while COVID-19 makes it more difficult to cope with substance use issues because of isolation and decreased access to services, those who use substances are at a greater risk of contracting COVID-19 and having severe outcomes.

For those left behind after a life ends from substance use, they struggle with grief, anger, guilt and heartbreak.

After the years of watching her husband suffer and try to support him, Bourgeois said she felt like she lost her husband all over again when he died.

“I really do feel like we lost Marcel two times - once to the mental health and addiction and then again when he took his life in March 2020,” Bourgeois said.

The mom of two boys, now 9 and 11 years old, has found good resources and support, like Stop Abuse In Families and Al-Anon, and wants to keep talking about mental health and addiction to raise awareness and reduce the shame and stigma.

“I think the only way we're going to get out of it is if we talk about it,” Bourgeois said.

Bourgeois said there needs to be more support for people suffering from substance use disorders because families can't support them on their own. When the worst case scenario happens and a loved one dies, the families are left picking up the pieces of their lives.

“We miss him dearly, even though the past two to three years were unbelievably hard and it is very frustrating to deal with a person caught in the throes of addiction and depression and anxiety. I miss the person he was when we first met. I miss my friend.”

Jennifer Henderson is the Local Journalism Initiative Reporter for Great West Newspapers, covering rural Alberta issues.