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March 3-7, 2026

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How to Address Opioids in the Workplace



opioids in construction

Combatting the opioid epidemic has become an issue of national importance. Opioid use is not only affecting families and communities, but also companies — particularly those in the construction industry.

The National Safety Council (NSC) conducted its Opioids at Work Employer Survey in early 2019. The results were more alarming than we had feared. Roughly 75 percent of people with a substance use disorder are in the workforce. At the same time, 75 percent of workplaces say they have already been impacted by the opioid epidemic. Here’s the really troubling part: Just 17 percent of employers feel like they are prepared to address opioid use among their employees.

The NSC has also examined how the opioid epidemic is affecting the construction industry in particular. The indicators are equally alarming.

A brief published in 2018 with data from 2011-2015 in Massachusetts, for instance, shows that overdose deaths in the “construction and extraction” occupation were six times higher than the average of all workers. While that statistic is rather shocking, it shouldn’t come as a complete surprise. The rate of fatal opioid-related overdose is always higher among workers in industries with above-average rates of illness and injury. Unfortunately, construction falls into this category.

It’s pretty simple: Construction laborers work really hard, oftentimes resulting in aches, pains and sometimes mental distress. A household survey conducted in 2010 found that one-third of construction workers reported back pain. Additionally, data from the 2018 Massachusetts study found that 74 percent of workers on a large commercial construction site reported having some kind of musculoskeletal pain.

With aches and pains come trips to the doctor — especially by patients eager to continue doing their jobs. The remedy is often an opioid prescription. In some instances, the unintended result is addiction.

Regardless of how an individual’s opioid use started or in what occupation, the adverse effects on a company can be devastating. Our Work Employer Survey found that 38 percent of employers have experienced absenteeism or impaired worker performance as a result of opioid use. More disturbingly, 31 percent have had an overdose, arrest, near-miss or injury due to employee opioid use.

The workplace has become an important battleground in our nation’s ongoing fight against opioid addiction. Data shows that employer-initiated and supported treatment has a higher success rate than treatment initiated by friends or family. Workplaces have a capacity to educate in a unique way. Now is the time for companies to put a plan in place to do just that.

Recognizing the Warning Signs

Employers can be on the lookout for some common warning signs of opioid misuse. While any single “symptom” may not individually signal a potential problem, the combination of several symptoms is often a good indication.

  • Shifts in appearance or hygiene
  • Sudden weight loss or gain
  • Tremors or unsteady walking
  • Mental impairment
  • Heightened irritability
  • Forgetfulness
  • Isolation from others
  • Loss of concentration
  • Tendency to lie
  • Performance issues

opioid crisisWeighing the Costs and Options

Many employers don’t know what their options are to address these issues. Many want to rely on drug testing. But that can be very costly and ineffective.

The NSC provides a substance use cost calculator on its website. An employer can select their industry, state and number of employees. The calculator uses the latest statistical data to estimate the annual costs of substance use in that workforce. For example, a construction company in Pennsylvania with 100 employees faces estimated annual costs of over $40,000 resulting from lost time, job turnover, retraining and healthcare.

Is there a better way to deal with opioid use in the construction workplace?

The NSC has found that people in recovery actually miss less work and generate less medical expense than the average person. People in recovery also tend to be more loyal when their employer supports their recovery. Thus, investing in things like return-to-work programs can have a financial benefit on the company.

In other words, a strategy based on compassion, communication and rehabilitation — as opposed to drug testing and termination — could be the best strategy for a construction company.

Breaking Down the Stigma, Building Up the Culture

There is a stigma when it comes to substance use disorders in the workplace. When employers ignore them, employees feel like they have to keep them hidden. However, employees should feel like the company supports them.

The NSC has outlined an 8-step plan to help companies begin addressing opioids in the workplace:  

  • Obtain senior leadership support
  • Engage and educate employees
  • Train managers and supervisors on their role
  • Encourage HR to create compassionate, comprehensive policies
  • Avoid a “one size fits all” approach
  • Update employer healthcare plans and pharmacy benefit programs
  • Create a safe, hazard-free work environment
  • Develop a workplace culture of health and wellness that supports recovery

The NSC has also developed a toolkit to help companies begin the communication and education process. The toolkit includes things like posters, stickers and other educational materials, as well as electronic documents that can be posted to a company intranet.

A Team Approach is Most Effective

Companies must recognize that there are likely some differences in how different types of employees view opioid use in the workplace.

Our research shows that safety personnel often feel like the company is less prepared to address opioid use, while HR and management often feel like the company is better prepared. This is a gap that requires action to fix.

Companies should adopt a team approach when building policies to address opioids. When everyone works together, the necessary cultural shift can occur.

Jenny Burke

About Jenny Burke

Jenny Burke is senior director of advocacy for the National Safety Council. Key accomplishments have included the benchmarking of employer data on the opioid epidemic and its impact on the workplace, and creating cost calculators to illustrate the effect of opioids and fatigue on a company’s bottom line. Visit for more information.


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