The opioid epidemic is one of the biggest health crises facing the United States, and it has shown no sign of slowing down. The construction industry has been particularly affected by this epidemic, as workers in this field are among the most susceptible to opioid abuse, according to a new report from Bisnow.

A 2015 report from CNA estimated that 15.1 percent of construction workers have engaged in illicit drug use, including both illegal and legal prescription drugs.

“While there is limited data illustrating the incidence of opioid abuse among injured construction workers, analysis of CNA claim data indicates the cost of opioid use is greater in construction than in other industries,” the CNA report states.

Males are twice as likely to abuse illicit drugs than females, and because construction is such a male-dominated workforce, the amount of opioid abuse is bound to be above average. However, other factors contribute to this trend. For one, construction workers often deal with wear and tear on the body that other lines of work don’t experience. This leads doctors to prescribe opioid medication, but that often is the first step toward abuse.

In most industries, the prescription opioid spend is approximately 10 percent, according to CNA. In the construction industry, it is about 20 percent, a figure the firm calls “problematic.” In the past decade, the opioid spend in the construction industry has consistently been between 5­–10 percent higher than all other industries combined.

The Bisnow report cites specific numbers that illustrate how devastating this epidemic has been. In Massachusetts, more than 2,000 were estimated to have died from opioid use in 2016. In Illinois, a 150-employee construction firm is facing more than $57,000 in lost time, turnover and healthcare expenses.

Experts have stressed that there should be a higher focus on rehabilitation and getting workers off opioids before it becomes a dependency. In addition, thanks to many zero-tolerance policies in the industry, workers that test positive are often terminated immediately without further help. Long-term, such policies are unlikely to have a positive impact.

Last week, the Trump administration declared the opioid crisis to be a public health emergency. It remains to be seen how much action this will inspire, but the construction industry as a whole will likely have to bolster its education and rehabilitation efforts if it hopes to effectively fight back.