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An organizer displays a naloxone kit that people can pick up for free as International Overdose Awareness Day training seminar takes place, in Victoria, in 2019.CHAD HIPOLITO/The Canadian Press

Construction workers have been disproportionately affected by the worsening opioid crisis, accounting for about one in 13 opioid-related deaths in Ontario between 2017 and 2020, according to a new report published Thursday.

The report, led by researchers from the Ontario Drug Policy Research Network (ODPRN), found 428 Ontarians who were working or previously employed in the construction industry died of opioid toxicity during the 30-month period they investigated. That amounted to 7.9 per cent of the total 5,386 opioid-related deaths within that time span, even though those working in the construction industry represent 3.6 per cent of the province’s overall population.

Nearly 80 per cent of these deaths occurred at the individual’s home, the researchers found. Very few occurred on a construction site or at a hotel or motel used for work purposes.

“That was really the first thing that stood out to us is that these are overdoses happening in people’s homes and they’re happening when there aren’t people around to intervene,” said lead author Dr. Tara Gomes, who is a principal investigator of the ODPRN, a provincial network of researchers.

Opioid toxicity deaths among Ontario

construction workers

Number of deaths,, quarterly

50

COVID state of

emergency

declared in

Ontario

40

30

20

10

0

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

2017

2018

2019

2020

the globe and mail, source: The Ontario Drug

Policy Research Network The Office of the

Chief Coroner for Ontario / Ontario Forensic

Pathology Service Public Health Ontario

Opioid toxicity deaths among Ontario

construction workers

Number of deaths, quarterly

50

COVID state of

emergency

declared in

Ontario

40

30

20

10

0

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

2017

2018

2019

2020

the globe and mail, source: The Ontario Drug

Policy Research Network The Office of the

Chief Coroner for Ontario / Ontario Forensic

Pathology Service Public Health Ontario

Opioid toxicity deaths among Ontario construction workers

Number of deaths, quarterly

50

COVID state of

emergency

declared in

Ontario

40

30

20

10

0

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

2017

2018

2019

2020

the globe and mail, source: The Ontario Drug Policy Research Network The Office of the

Chief Coroner for Ontario / Ontario Forensic Pathology Service Public Health Ontario

One of the most immediate measures that can be taken to prevent further deaths is to improve access to the overdose-reversing drug naloxone in people’s homes, and encourage people to ensure they have someone around who is trained to use naloxone when they’re using substances, said Dr. Gomes, who is also a scientist at the Li Ka Shing Knowledge Institute at St. Michael’s Hospital in Toronto and ICES (formerly known as the Institute for Clinical Evaluative Sciences).

This latest report builds on the researchers’ earlier findings in 2021 that about 30 per cent of people employed at the time of an opioid-related death worked in the construction sector. The second-highest proportion of such deaths were among those employed in the retail sector, with 5.7 per cent, Dr. Gomes said.

When it comes to opioid-related deaths, “the construction industry stands out far and above every other industry,” she said, explaining there may be a combination of factors involved.

There is a fairly high prevalence of people in the industry who have injuries and pain, Dr. Gomes said. If those conditions are not sufficiently treated, and if people don’t have the benefits needed to access medication or other pain management, they may rely on the unregulated drug supply, she said.

Dr. Gomes noted the majority of opioid-related deaths occurred among people overdosing on fentanyl and also using other drugs, including cocaine and alcohol. People experiencing job insecurity and non-standard work arrangements may also not report injuries or seek support for substance use disorders, she added, since there may be pressure to return to work quickly.

According to the report, mental-health issues associated with long hours and stressful work environments could also contribute to opioid use.

Besides ensuring that people have naloxone at home and aren’t using drugs when alone, Dr. Gomes also emphasized the need to reduce the stigma around substance use and provide low-barrier access to treatment.

Carmine Tiano, director of occupational services at The Provincial Building and Construction Trades Council of Ontario, which represents construction workers in the province, said in order to encourage people in the industry to seek help, it’s important to spread the message that any substance use or mental-health issues they have do not define them.

“If you get that out there – that what you do and what you have isn’t who you are – it starts breaking down the stigma,” Mr. Tiano said.

He said the government can play a role in making sure appropriate treatment options are available, so that substance use and other underlying conditions are treated in tandem. Meanwhile, both employers and workers should consider whether it’s feasible to have people working 14-hour shifts, for two to three weeks at a time, which often occurs in certain trades, he said.

“We’ve been socially conditioned it’s good to work long, long hours,” he said. “But that’s not a good thing … Your body starts to break down and people look for alternatives to feel better.”

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