Use of unregulated drugs contributing to opioid toxicity deaths among construction workers
A new report by the Ontario Drug Policy Research Network (ODPRN) looks at the extent to which unregulated drugs are driving opioid deaths among construction workers.
The report, Lives Lost to Opioid Toxicity among Ontarians who Worked in the Construction Industry, shows that among those people who died from opioid toxicity in Ontario between 2018 and 2020, one in 13 was a construction worker, and half of those people were employed at the time of their deaths.
The report blames the deaths on the use of unregulated drugs such as cocaine and alcohol as being most commonly involved in opioid toxicity deaths among construction workers compared to those not working in the construction industry. It also calls for the construction industry to take steps to recognize the stigma around drug use, which may make people less likely to seek help.
The report was led by researchers from the ODPRN, the Office of the Chief Coroner for Ontario and Public Health Ontario.
“The disproportionate impact of Ontario’s overdose crisis among people working in the construction industry demands further attention,” said Dr. Tara Gomes, lead author of the report and a principal investigator of the ODPRN. “Despite a high prevalence of pain among workers, prescription opioids are not driving the patterns seen in this industry, with most deaths involving a combination of opioids with other drugs and alcohol. This could reflect a reliance on non-prescription opioids to manage unresolved pain in a sector where workplace culture and lack of job security can lead to under-reporting of injuries and pressure to minimize recovery time.”
Over the study’s 30-month span, 428 Ontarians with employment history in the construction industry died of an opioid toxicity, accounting for nearly 8 percent of opioid toxicity deaths during that time. In contrast, people working in the construction industry represented only 3.6 percent of the entire Ontario population and 7.2 percent of all employed people in Ontario in 2021.
Using data from health researchers ICES and the Office of the Chief Coroner of Ontario, researchers also found that fentanyl and cocaine involvement were significantly higher among construction workers. Alcohol also directly contributed to one in five opioid toxicity deaths among construction workers, which was significantly more common compared to those without a history of employment in construction
Additionally, nearly 80 percent of opioid toxicity deaths among construction workers occurred in private residences, most often the individual’s home, and rarely at construction sites or motels/hotels used for work purposes.
Also troubling were the facts that just one in six construction workers with an opioid use disorder diagnosis who died of an opioid toxicity had accessed treatment in the month before death. That figure is lower than what was observed among those with no history in construction.
Additionally,
- Nearly 60 percent of individuals in the construction industry were employed at the time of opioid toxicity death, compared to only 12 percent of those with no employment history in the construction industry.
- Pain was highly prevalent among construction workers who died of opioid toxicity – almost 80 percent experienced a pain-related condition or injury in the five years prior to opioid toxicity death, which was similar to those with no employment history in construction.
- Opioid toxicity deaths were more concentrated among those aged 25 to 44 years, with almost two-thirds of deaths among people who worked in the construction industry falling in this age group.
- Over 98 percent of construction workers who died of an opioid toxicity were male, compared to 72 percent among those without a history of employment in the construction industry. This is consistent with the sex distribution of the construction industry workforce in Ontario.
The report authors are calling for responses across the construction industry that recognize the stigma around drug use, which may make people less likely to engage in treatment and harm reduction services offered through their employer.
They recommend responses include improving access to naloxone within homes, raising awareness about how to use drugs more safely and using multiple drugs, and providing low-barrier access to evidence-based treatment – such as removing the requirement to go to a pharmacy to consume a daily dose methadone or buprenorphine – as well as pain management and mental health supports.
“The report shows that young men continue to die from preventable opioid-related deaths,” said Ontario’s Chief Coroner Dr. Dirk Huyer. “Each death is a person who lost their life. Their families have lost a loved one, their communities have suffered a loss, and coworkers have lost a colleague and friend. Developing policies to address the stigma and provide support and harm reduction services at the workplace will help prevent further opioid-related deaths.”
The report was funded by the Government of Ontario and the Canadian Institutes of Health Research.