As an industry, construction has been beset by the national opioid epidemic. In Rhode Island, a report by public-health officials found that about 20% of people who had died between June 2016 and June 2018 had last been employed in construction.
That overrepresentation has helped to spur more inward looking and inspired specialized training for workers, as well as supervisors, in how to respond when someone is overdosing. In a training series developed by the construction training organization Building Futures, construction workers are receiving hands-on education in how to help co-workers and friends survive an overdose and find resources for treatment and recovery.
Andrew Cortés, executive director of Building Futures, said the industry has an opportunity to empower people to help other workers who are struggling. He knew construction was overrepresented in opioid deaths and had braced himself for the Rhode Island data when a similar percentage was reported in Massachusetts.
“The reason we developed this customized training is because of the disproportionate impact that the construction industry has felt related to the opioid crisis,” he said. “While every town and city is impacted, disproportionately the data shows construction workers are impacted more.”
How much is the difference?
The Rhode Island data showed 17 out of 10,000 people employed in construction have died of an overdose, compared with four out of 10,000 in the general workforce, according to Jill Sypole, a licensed clinical social worker and the health initiatives manager at Building Futures.
For the managers at Building Futures, the statistics were not just numbers.
“It wasn’t anecdotal for us. We lost graduates,” Cortés said. “We’re responding as an industry but also as an organization. These are our family, our graduates. People who are looking to get on a better path to the middle class.”
‘It wasn’t anecdotal for us. We lost graduates.’
Andrew Cortés, Building Futures executive director
One of the benefits of nonresidential unionized labor, he said, is a training infrastructure. The specialized training that started in May supplements existing programs, including employee-assistance programs.
The opioid training focuses on three areas: prevention, support and rescue, including helping workers in a male-dominated industry find ways to talk about their stress or pain and find ways to find professional or peer help.
The training starts with the distribution of “cellphone resource cards,” which have helpful apps and phone numbers for counseling and other services. The trainees are told to take a photo of the cards, so they’ll have the resources handy.
In practical terms, the rescue training also involves hands-on instruction in administering naloxone, a medication sold under the brand name Narcan that can counteract the effects of an overdose.
Linda Hurley, CEO and president of CODAC Behavioral Healthcare, which provides services and treatment for people living with addiction, said the new training sounded like a smart response.
“What needs to be happening … is we have to keep the conversation going. Whether we like it or not, this has become a disease that has become normalized because it’s so rampant. So, let’s talk about it. This is a great forum in which to do this.”
She said she was startled when she read that a report by the National Safety Council, based on employer surveys of thousands of companies, found 75% of them had been impacted by the opioid epidemic. Oftentimes, she said, addiction appears first in behavioral problems that managers will notice, such as absenteeism, punctuality problems, car or workplace accidents. “Things start to happen that give some insight,” she said.
Why are construction workers so heavily affected?
Hurley said the argument that construction workers are medicating injuries is anecdotal. She looked at the health data and found that the use of alcohol and other drugs were often found alongside the opiates. “Why does that happen? I don’t know. More people are stricken by this disease who have a high school diploma, a GED, or lower. Does that mean anything? I don’t know,” she said.
Cortés said his understanding is that the addiction starts with medications taken for pain management.
“If you don’t work, you don’t get paid,” he said.
In recent months, several major construction employers have responded in more active ways. Several have instituted policies that require the presence of lifesaving naloxone on every job site, he said.
These companies include Gilbane Building Co. and Dimeo Construction Company, according to Cortés.
He thinks that’s an appropriate response. Moreover, he thinks every employer in Rhode Island should have it available in the workplace. He likened it to a defibrillator, which can save people who are having heart attacks. Naloxone can be administered as a spray absorbed in the nose, or in liquid form injected into a muscle.
Employers do not need a prescription from a physician to obtain the drug. Rhode Island has an “open prescription” policy for the drug at pharmacies, allowing anyone to obtain it without a prescription.
More widespread access to naxolone would be helpful, Sypole said, because in Rhode Island, one out of three fatal overdoses have happened in public spaces, including sidewalks and parking lots.
“It’s so important that we destigmatize this,” Cortés said.
Mary MacDonald is a PBN staff writer. Contact her at Macdonald@PBN.com.