New research affirms construction workers disproportionately affected by opioid deaths

Researchers hope a new report examining the occupations of people who have died of opioid overdoses in Ontario raises awareness about the breadth of the population affected by the drug epidemic.The study found that more than a third of opioid-related deaths between 2018 and 2024 where the person's occupation was known were people who worked in construction or the trades. That's roughly 1,340 people. Overall, opioid deaths in Ontario for that time period totalled nearly 16,000, but the coroner only recorded the occupations in about 22% of the cases. Principal investigator Tara Gomes says the research reaffirms previous findings that construction workers are disproportionately affected by the opioid epidemic.But she notes that the new research also shows the rate of opioid deaths was similar for workers in natural resources and agriculture. Data shows roughly 32 opioid deaths per 100,000 natural resources workers in 2024, compared to 54.5 opioid deaths per 100,000 construction workers that same year. The total number of workers in natural resources and agriculture is much smaller than those in construction and the trades, meaning that demographic may have been previously overlooked.The researchers said occupations where there is more risk for injury, precarious employment and shift work could be factors that make people more vulnerable. The rate among hospitality workers—also worryingly high, researchers say—was 8.9 deaths per 100,000 workers in 2024. “I think a lot of people have a picture in their mind as to the opioid toxicity crisis, who is experiencing loss of life,” Gomes said, adding that in some cases there may be a link between people's overdose use and their working conditions.For example, she noted that the occupations most affected by opioid deaths often don't come with job security or health benefits.“If you don't have prescription drug benefits and you experience pain, then are you able to pay for prescribed opioids?” she said.“And if you're not, then are you turning to the illicit drug supply to help manage that pain? That's certainly a concern in sectors like construction and trades, but could be the case in retail and hospitality as well.” Gomes also pointed to the study's findings around what other substances people had in their systems when they died.Of those in construction and the trades, 49% had cocaine in their system at the time of their death, while nearly 23% had amphetamine in their system. For those in hospitality, the rates were nearly 45% and 22%.Both drugs are stimulants, which Gomes said “relates to occupations where there is shift work with very long hours, because people will often use the stimulants to counteract the (sedative) effects of the opioids.”She said opioids tend to slow the breathing down, while stimulants speed the heart up. “Your body's going to be pulled in all these directions and it can put a lot of strain in particular on your heart,” she said.“So if you have some heart issues and then your respiratory system is failing, that's obviously a really dangerous situation.”Researchers found 15,952 opioid toxicity deaths in Ontario over the study period, but the coroner only recorded the employment status and field of work for 3,534 of those people. Of those, roughly half were employed at the time of their death.Another 3,732 were known to be unemployed but the coroner did not know what industry they had last worked in. There was no employment data available for 8,686 of those who died. Shaleesa Ledlie, a senior research associate with the network, said that's because of how the data was collected.When a person dies unexpectedly in Ontario, the coroner's office investigates the circumstances surrounding their death, including by interviewing those close to the person.If the friends or family of the person who died weren't aware of where they had last worked, then the coroner's office couldn't record it.She said the people whose field of work was unknown were likely unemployed for a long period of time before their deaths, while those who have an occupation may have been employed more recently.“It shows us that the period immediately following unemployment can be a higher risk period for experiencing some of these harms,” she said.That also means that as public health agencies and industry groups consider how they offer resources to people, they need to think outside of the workplace, she said.“If someone's unemployed, they often do not have access any longer to their private health benefits or any type of mental health or wellness supports and the social aspects of being employed,” she said.Dr. Leslie Buckley, chief of the addictions division at the Centre for Addiction and Mental Health, said the report “is an important step in trying to deepen our understanding about the factors contributing to” the problem of opioid overdoses in the trades.“As a next step, we need to think about how we can help to reduce this elevated risk by exploring innovative new solutions to help,” she wrote in an email.

New research affirms construction workers disproportionately affected by opioid deaths

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