Construction policy makers are being urged to continue to press for solutions to the acceleration of opioid-related deaths that plague the Ontario’s construction sector.
The Ontario Drug Policy Research Network (ODPRN) and partners have followed up on their alarming report from May of 2021 that showed that among people who died of opioid toxicity in the province between 2017 and 2020, one-third of those who were employed at the time of death worked in the construction industry.
The new report shows deaths among construction workers are primarily being driven by the unregulated drug supply, not pharmaceutical opioids prescribed for pain, with cocaine and alcohol being more commonly involved in opioid toxicity deaths among construction workers compared to those not working in the construction industry.
Almost 80 per cent of opioid toxicity deaths among construction workers occurred in a private residence, most likely with no naloxone kit available.
The authors of the report are calling for industry-level responses that recognize the stigma around drug use, which may make people less likely to engage in treatment and harm reduction services offered through their employer.
“I think there’s a lot that can be done just by knowing some of the circumstances around deaths, the kinds of substances that are involved, how people are engaging in the health care system before they have one of these fatal overdoses, to see where there might be opportunities to intervene and to better support people,” said lead report author Dr. Tara Gomes, a scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and principal investigator with the ODPRN.
The new report, released in July and titled Lives Lost to Opioid Toxicity among Ontarians who Worked in the Construction Industry, was produced by the ODPRN, the Office of the Chief Coroner for Ontario and Public Health Ontario. The original report found that 2,500 Ontarians died of drug overdoses in 2020, up from 1,500 in 2019.
“There are those elements to this report where we saw that there’s a high degree of injuries, reported pain and a high degree of mental health diagnoses, in particular things like anxiety and depression, and so there’s a concern that this is a population that’s struggling with unresolved pain, having to work through that pain and also they’re also dealing with depression and anxiety,” Gomes said.
There were 428 opioid toxicity deaths among workers who had a history of employment in the construction industry from July 2017 to the end of 2020 in Ontario.
Construction workers accounted for nearly one in 13 opioid toxicity deaths across Ontario over this time.
Fentanyl and cocaine involvement are significantly higher among those with employment history in construction compared to those without. Alcohol directly contributed to one in five opioid toxicity deaths among construction workers, which was significantly more than those who never worked in construction.
“About 90 per cent of the deaths happen to involve illicit opioids, such as heroin and fentanyl, which implies that this isn’t a situation where people are injured,” said Gomes. “They’re accessing medication for pain from a doctor and are just somehow having an accidental overdose from those prescribed drugs. They’re actually accessing opioids from the illicit market.”
Construction is unique with its odd and long shifts, Gomes explained, combined with workers using stimulants to stay alert and also managing pain. When a shift is done they may go home and use opioids and alcohol to unwind and manage the pain.
The Ontario government has increased access to naloxone, which treats opioid overdoses, and employers and researchers are coming to grips with the acceleration of the problem, which was exacerbated by Covid, Gomes said. The new ODPRN report creates another level of understanding.
“One of the things that stood out to us that we hadn’t necessarily expected was that it was incredibly common for these deaths to happen at people’s homes. And most of the time they were alone at the time of death. And even if there was someone there who could intervene, only half of the time was Naloxone used.”
A range of industry-level responses are recommended, including improved access to substance use treatment and harm reduction and raising awareness about the risks of polysubstance use and using drugs while alone.
“Adequate workers’ compensation benefits, specific supports for temporary workers, and comprehensive post-injury care that is accessible, patient-centred, and multidisciplinary should be considered as core elements to any response to opioid-related harm in the construction industry,” the report concluded.
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