- Opioids, especially fentanyl and its illicit derivatives, rapidly increased overdose deaths in the U.S. between 2013 and 2016.
- Work-related musculoskeletal disorders affect construction workers disproportionately, leading to chronic pain that doctors often treat with opioid pain relievers.
- Opioids are just one of many substances that are misused and abused by those in construction.
It’s hard to know the true effect of opioids on construction because opioid-specific data directly related to the industry is scant, often anecdotal, and sometimes just irrelevant. However, there are three important aspects of opioids that employers should be aware of so that you can assess how misuse or abuse of opioids (or other substances) might affect your business.
If you know the types of opioids, you can understand the sources of opioid problems.
Opioids come in many forms, prescription and illicit. People misuse all forms. Opioids include opiates like heroin, morphine, and codeine, all derived from the poppy plant. Opioids also include any synthetic or semi-synthetic substances that bind to the brain’s opioid receptors. Finally, the human body makes its own opioids to block pain, slow breathing, calm anxiety, and reduce depression. However, the opioids the body produces can’t stop severe pain—or cause an overdose.
Synthetic opioids, especially those related to illegally-manufactured fentanyl, are primarily responsible for the rapid increase in opioid overdose deaths from 2013 through 2016. Over half of those deaths also involved other opioids, including heroin, or other illicit drugs. That said, anytime fentanyl or fentanyl analogs are involved in deaths, they are the main cause.
If you know why people use opioids, you can understand the role construction work plays in opioid use and misuse.
Even with some new technologies that help lighten the impact of construction work on the body, construction jobs are still very physical, This means they can lead to work-related musculoskeletal disorders, or WMSDs. In fact, the rate of WMSDs in construction is higher than in all other industries combined.
WMSDs are mainly due to overexertion. Repetitive motion, forceful movements, working in awkward positions, doing tasks requiring you to strain your muscles, lifting while twisting, and staying in one position for long intervals can all take a toll on tendons and muscles. Besides pain and suffering, WMSDs account for increased days away from work, and they disproportionately affect people between 55 and 64 years old.
People suffering from the continual pain of WMSDs often get prescription pain relievers. It follows, then, that doctors would write more pain relief prescriptions for people in construction. Nevertheless, almost 90 percent of people taking prescription drugs don’t misuse them. The same holds true for prescription opioids.
When people do misuse prescription pain relievers, 60 percent do so to relieve pain, while 3.2 percent do so because they feel hooked.
“The vast majority of patients who use prescription opioids, either short or long term, do not progress to misuse and are unlikely to transition to heroin use,” states the November 2017 recommendations by the President’s Commission on Combating Drug Addiction and the Opioid Crisis.
When people do misuse prescription pain relievers, 60 percent do so to relieve pain, while 3.2 percent do so because they feel hooked. People seeking pain relief sometimes progress to stronger drugs like fentanyl, prescribed or no.
The Substance Abuse and Mental Health Services Administration defines ‘misuse’ as any use not directed by a doctor. That includes using someone else’s prescription drugs, a prime way people access drugs like oxycodone, hydrocodone, and morphine. Misusing and abusing substances is a problem for construction employers.
If you know the scale and details of substance misuse and abuse in the construction industry, you can assess its effects on your business.
Opioid misuse and abuse in construction is part of the larger issue of substance misuse and abuse. In the National Survey on Drug Use and Health (NSDUH) combined statistics for 2008-2012, 11.6 percent of construction workers reported using illicit drugs in the month prior. NSDUH defines illicit drugs as marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, and prescription-type drugs used non-medically. That places construction as the fifth highest abuser among all industries, behind accommodations and food, arts and entertainment, management, and information.
Construction’s most abused legal substance is reportedly alcohol, with 16.5 percent of respondents saying they used it heavily in the month before the survey.
What’s the upshot for construction, and you?
If you want to make the statistics about substance abuse and misuse very relevant to your business, use the National Safety Council’s Substance Use Employer Calculator. Enter your state, industry, and how many employees you have, and get an instant report on the effects of substance use in your workforce. The calculator uses data from the NSDUH and includes cost estimates for lost time, job turnover, and healthcare.
Recent trends in reporting cite general statistics on substance abuse—or deaths attributable to multiple substances—as evidence there is an opioid crisis in construction. This could be misleading, however, and cause employers to focus on trying to solve the wrong problems.
Work-related musculoskeletal injuries are a leading cause of opioid use in construction. When workers use opioids for reasons unrelated to relieving pain, it adds to construction’s larger substance abuse problem. One avenue for combatting that problem is through health and safety education; another is through preventative safety measures that aim to reduce the incidences of long and short-term bodily trauma, and hence the need for prescription painkillers.