Opioids and Substance Use Disorders in the Construction Industry

Opioid death rates in the AEC industry are nearly four times the national average. Management and labor need to know the warning signs of opioid abuse and be ready to take the right actions immediately.
By Marko Kaar
August 24, 2018

The AEC community has a problem. And it’s time to start talking about it. Opioid death rates in the AEC industry are approximately four times the national average.

A recent study in Massachusetts provides one specific example, which indicates a rate six times the state average1. These numbers also reflect that the number of deaths is not proportional with the construction industry’s percentage of employment. In fact, construction accounts for approximately four percent of the employed population, but nearly 25 percent of the overall opioid deaths in Massachusetts. This disparity beckons further attention.

According to a 2016 Centers for Disease Control study, suicides in the AEC industry total nearly six times the national average as well, at 85.5 per 100,000 workers. In 2015 (the last year for which full data is available) approximately 44,193 people died by suicide in the U.S. Approximately 13 percent (10.8 percent construction, 2.2 percent AE) of that number, or 5,745, estimated people died by suicide that year in the combined construction, extraction and architecture/engineering industry group2. Moreover, substance misuse and addiction affect twice as many construction and AE workers as the national average3.

The AEC industry concentrates significant efforts to prevent falls, struck-by, caught-in-between and electrical contact hazards as leading causes of death in the construction workplace (the so-called OSHA Focus Four or Fatal Four). This is incredibly important, as nearly 90 percent of all OSHA-related deaths can be attributed to these hazards annually. That’s about 900 employees a year4.

However, is sufficient focus aimed toward the right problem? It is clear that the overall mental health in the U.S., and especially within the AEC industry, is a contributing factor in more opioid overdose and suicide deaths annually than the number of annual deaths from the Focus Four.

Here are some additional statistics:

  • one in five American adults will have a diagnosable mental health condition in any given year; and
  • 50 percent of Americans will meet the criteria for a diagnosable mental health condition sometime in their life, and half of those people will develop the onset of these conditions by the age of 14.

Mental health issues, addiction and suicide are not typical focus areas for AEC companies. There is a stigma associated with overall mental health that can inhibit discussion and create an inability to seek help, resulting in individuals and their families suffering in silence and shame. These challenges extend from the office to the jobsite and then to the home. There is an emotional and financial toll that is impacting the industry in many ways – and it is not talked about .

Typical Risk Factors (and stereotypes) in Construction

Each one of these risk factors (or stereotypes) has a great deal of truth to them. The AEC industry is fluid, high risk and stressful. Its workers are more prone to significant injury than most other industries. Nearly everyone in the industry has faced at least one of the challenges above and many times multiple challenges contemporaneously.

The AEC industry has to take the time to become educated regarding the effects of mental health in the workplace. There must be greater recognition and understanding of the difference between acute effects (e.g., signs of intoxication) and chronic effects (e.g., the mania and clinical depression associated with bipolar disorder).

Until the AEC industry is fully informed, committed and focused on the problem proactively, nothing substantive is going to change. Construction managers don’t send crews to a jobsite without the proper tools to complete the work, so why is it acceptable to send them out with inaccurate or misleading information on the greatest workforce crisis the industry is currently facing?

Education can only come through meaningful conversation. Training is one component of the process, but many times training gives only the “what to do” and not the “why to do it.” It is important to increase the collective knowledge of these topics. More importantly, it is imperative to increase understanding and compassion.

Management and labor must be in lockstep on this issue with no finger-pointing and avoiding the not-in-my-backyard attitude. Everyone from the supervisor down to the newest apprentice needs to know the warning signs of opioid abuse and what to do when they suspect there’s a problem either with them or a coworker. They have to understand when a coworker is suicidal, and be prepared to ask “are you okay?” They must truly listen to their response and be ready to take the right actions immediately.

The challenges exist at every level of virtually every organization. No organization is immune from this public health crisis. If the president of the company has an issue, then don’t all of his or her employees? The same is true of the entire industry – leadership shares the problems and the solutions with their subordinates. It’s not “them,” it’s “us.” The AEC industry has a problem. It’s time to start talking about it. And, perhaps, it’s time to start working on the “Focus Five."

by Marko Kaar

 Marko Kaar has been working in the construction industry since 1983, and focused on construction safety as a career since 1989. He has worked with and for contractors large and small, around the country – consulting, training, motivating, and driving the message of life, health and safety as core values of any organization. His varied background and field experience give him a unique outlook on the concepts of safety culture, risk management and employee engagement. Equally at home in the field or in the boardroom, he continually presses for change and improvement in our fast-paced industry.

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