Safety Leader

Under the Influence

Under the Influence
Published On
Aug 7, 2020

The opioid addiction crisis is becoming an increasingly debilitating problem throughout the country and is prevalent in all industries. Construction workers, however, are the most susceptible to becoming addicted to opioids. In fact, according to a recent New York University study in the journal Drug and Alcohol Dependence, these workers are among the most likely to abuse all drugs. It is imperative to understand the dangers associated with opioid abuse and addiction as well as know how to avoid it.

The most dangerous and addictive drugs are prescription opioids. These include hydrocodone (Vicodin), oxycodone (OxyContin and Percocet), morphine (Kadian) and codeine. Opioids are prescribed by doctors following a surgery, an injury or to patients afflicted with some other chronic health condition. When these medications are used as intended, they are immensely helpful in managing pain. However, they often result in side effects that can cause mental confusion, nausea, drowsiness, constipation and even altered breathing.

These drugs are commonly prescribed to and used by construction industry workers as a result of repetitive stress injuries and ailments caused by the physically demanding nature of the work. Since failure to perform could result in job loss, this creates the perfect storm of exponential risk factors for becoming dependent on these drugs. Furthermore, when they are mixed with alcohol, the risk compounds ten-fold. 

Abuse of prescription medications can lead to the use and dependency of illicit drugs such as cocaine, heroin and fentanyl. Workers are often drug-tested as part of the hiring and pre-employment screening process, but they are far less frequently tested on a recurring basis.

Unfortunately, according to the Insurance and Risk Management Institute, it is not uncommon for 25%–35% of pre-employment drug tests to come back positive in the construction industry. What’s more shocking? As many as 5% still test positive for drugs, even when they know in advance that they are going to be tested.

Workers under the influence are often around extreme job hazards and may operate heavy machinery, vehicles and other dangerous equipment. Employers can be held liable if an accident occurs, even under these circumstances. This demonstrates the importance of having stringent drug policies and regular testing protocols in place. 

According to Danielle Ompad, associate professor of epidemiology at NYU College of Global Public Health, deputy director of Center for Drug Use and HIV/HCV Research, “In the high-risk settings of construction work, where safely handling hazardous equipment is critical for reducing harms for workers, drug testing and other workplace substance use policies may play a role in protecting workers.” 

However, Ompad also noted, “Not all opioid use is problematic and drug testing cannot distinguish recreational use from medical use. Thus, strict workplace drug policies also have the potential to harm companies and reduce employment opportunities for workers. Coupled with reports of high overdose mortality among construction workers, our findings suggest that prevention and harm-reduction programming is needed to prevent drug-related risks and mortality among this population.”

In addition to drug screening, employers can take other measures to reduce the risk of workers becoming dependent on opioid drugs. Providing education and training on the dangers of these substances and offering anecdotal information demonstrating the consequences of addiction can be effective in preventing abuse. Employers that offer social support networks for injured workers can greatly decrease the probability of abuse and addiction. In addition, researchers have indicated that strong social networks can even reduce the number of lost workdays and lower overall wage loss. They also lead to better company-wide worker morale.

It is important to understand that drug addiction is a disease. There is no way to completely eradicate it in the workplace or society in general. However, being vigilant and proactively raising and maintaining awareness of the problem can be very helpful in minimizing risk. Counseling and treatment for those that fall victim to opioid dependency can also be highly beneficial. If you or a colleague is battling addiction, seek counseling as soon as possible and don’t be afraid to talk to someone.

About the Author

Tom O'Connor

Safety Columnist

Tom O'Connor is safety and regulatory affairs manager for Intec, a safety consulting, training and publishing firm that offers on-site assistance and produces manuals, training videos and software for contractors. Reach him at


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