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That year, the toll surpassed 110 workers, accounting for 18% of the state性视界传媒檚 workplace deaths, compared to 11% nationwide.

Federal and state government experts have raised the alarm over this trend, which has puzzled some policymakers because drug use is not a hazard created directly by the job. After all, those who die of an overdose at work represent a small share of thousands of Californians who overdose each year.

Still, business owners and union officials alike are increasingly having to grapple with one of the nation性视界传媒檚 most prominent public health challenges.

性视界传媒淲hen fentanyl came around, we started having a huge uptick in overdoses and deaths 性视界传媒� even suicides,性视界传媒� said Paul Moreno, president of Ironworkers Local 433 in Southern California.

In 2022, his local began holding recovery meetings for members that now draw as many as a dozen attendees a month. Moreno, who said he性视界传媒檚 been sober 19 years, visits worksites and the union hall passing around the 988 mental health crisis hotline number, giving out his own personal phone number and distributing doses of the overdose reversal drug naloxone (commonly sold as Narcan).

性视界传媒淚 took Narcan classes, I passed out Narcan on the job sites. I never thought I性视界传媒檇 be doing that,性视界传媒� he said. 性视界传媒淭he phone calls from the members, sometimes I don性视界传媒檛 know what to say, besides listen. We still need more training.性视界传媒�

A new California law directs the state性视界传媒檚 workplace safety agencies to require worksites to stock Narcan in their first aid kits, but the regulations haven性视界传媒檛 been issued yet. A spokesperson said Cal/OSHA is 性视界传媒渋n the early stages of rulemaking,性视界传媒� a process that could take years.

Not much is publicly known about overdose deaths at California worksites. A small office in Cal/OSHA that compiles workplace fatality data has for at least the past two years noted the rise in overdoses in its annual reports. But the office says it cannot release details due to privacy restrictions.

The agency has not responded to a public records request CalMatters filed in September for all overdose incidents, fatal or nonfatal, that have been reported at worksites.

State won性视界传媒檛 release details on deaths

County coroners性视界传媒� offices, which investigate some deaths, vary widely in whether they can identify incidents based on whether a person died at their job. Death records from the past three years obtained from Alameda, San Bernardino and Riverside counties provide glimpses into the grim trend.

In 2021, a flooring installer stepped out for a smoke break at a construction site in Temecula, and was found by coworkers on the side of the house, dead from a fentanyl overdose. A packing plant worker in Corona went to the bathroom and did not return; coworkers found him bent over with a straw, lighter and piece of foil nearby, having overdosed on methamphetamine, fentanyl and heroin. In Fremont, a manager found a night-shift janitor in the bathroom with a white powdery substance, overdosed on fentanyl. In Livermore this year, a driver was found in his parked semi-truck as he waited to make a scheduled delivery, also dead from fentanyl.

California officials have little to say about the rising death toll. Cal/OSHA refused to make an official available for an interview and would not explain why overdoses account for a much higher share of the state性视界传媒檚 workplace deaths compared to the rest of the nation.

Instead, the agency cited the broader national opioid crisis. 性视界传媒淐alifornia had more than 7,000 people die from opioid-related overdose deaths in 2022,性视界传媒� spokesperson Erika Monterroza wrote in an email. 性视界传媒淯nfortunately, these deaths happen all over our state, including in our workplaces.性视界传媒�

The state Department of Public Health says it is considering a study. That agency性视界传媒檚 occupational health branch is 性视界传媒渁ware of this issue and is considering a project to examine all opioid overdoses by industry and occupation,性视界传媒� a spokesperson said. In October, the department said staff are in the 性视界传媒渋nitial stages of preparing for an analysis性视界传媒� but did not provide a completion date.

Studies in other states indicate the problem is worse in certain industries. In Massachusetts, where overdoses are the top cause of workplace deaths, researchers with the state public health agency examined all overdoses deaths 性视界传媒� whether at work or not 性视界传媒� and found deaths occurred disproportionately among those working in manual-labor, high-injury industries.

Those jobs, said Emily Sparer-Fine, director of the Massachusetts public health agency性视界传媒檚 Occupational Health Surveillance Program, are often seasonal or unstable, and workers may be financially strained and pressured to work through pain.

性视界传媒淐ertain industries and occupations, (such as) construction, fishing, had a much higher rate of overdose,性视界传媒� Sparer-Fine said in an interview. 性视界传媒淏ut it was also jobs that had lower access to paid sick leave, higher rates of job insecurity, higher rates of overall workplace injury.性视界传媒�

In a new study this year, Sparer-Fine性视界传媒檚 team also dug into workers性视界传媒� compensation data and found working-age Massachusetts residents were 35% more likely to have died of an overdose if they were previously injured on the job.

Workers in similar industries are overrepresented in the California workplace overdose deaths, including in trucking and warehousing, according to federal data.

So are workers in construction, where unions and employers are confronting a mental health and addiction crisis. Nationwide, construction workers are more likely than workers in any other profession to overdose, and also have one of the highest rates of suicide.

Chris Trahan Cain, executive director of the national Center for Construction Research and Training, has since 2018 led the response to the industry性视界传媒檚 opioid crisis. She has focused on a longtime reliance on painkillers to deal with injuries involving the muscles and bones, which nearly a third of construction workers report experiencing. Studies like the ones in Massachusetts were among the first to reveal the toll.

The center, formed by the nation性视界传媒檚 construction unions, has recommended stocking naloxone in union halls, requiring apprentices be taught about opioid abuse and ensuring members have coverage of drug treatment programs. They性视界传媒檙e also providing tips on talking to doctors about how to treat injuries without long-term opioids prescriptions. The goal, Cain said, is to avoid blaming individual workers.

性视界传媒淲hen this information first came to light, what I heard was, 性视界传媒極h, it性视界传媒檚 just the macho culture, it性视界传媒檚 the type of people who go into construction,性视界传媒櫺允咏绱綕 she said. 性视界传媒淲e can性视界传媒檛 tell you how many of these deaths are because somebody started on a prescription, but we know that some of them are. We know a lot of these deaths are also from illicit drug use that have nothing to do with workplaces, but where we can (make) changes as an industry to impact these numbers, is what we性视界传媒檙e trying to do.性视界传媒�

Businesses respond to crisis

Employers, too, are trying to break the stigma for seeking help. Since 2021, the Associated General Contractors of California has provided materials to hold jobsite meetings about mental health.

Not all employers know how to raise the issue and some fear reprisal for appearing to pry into employees性视界传媒� personal lives, said Frank Nunes, CEO of the Wall and Ceiling Alliance, a Northern California specialty contractors性视界传媒� group. Some, Nunes said, are advised by attorneys to avoid talking about it.

性视界传媒淚t性视界传媒檚 still very sensitive,性视界传媒� he said. 性视界传媒淵ou性视界传媒檝e got to be very careful how you ask somebody how (they性视界传媒檙e) doing and not offend them.性视界传媒�

Still, Nunes joined officials of District Council 16 of the International Union of Painters and Allied Trades at a recovery event in San Leandro in October, promoting treatment programs covered by their contracts and encouraging workers to use them.

性视界传媒淲e have to address these things in the field,性视界传媒� he told about 100 union members. 性视界传媒淭here性视界传媒檚 a cultural change we all need to work on.性视界传媒�

In a cavernous training hall where apprentices learn how to install drywall, union members told their peers how they had recovered from addiction. The union invited former Raiders tight end Darren Waller to talk about his own experiences with addiction and depression.

Reflecting on union officials性视界传媒� numbers on construction worker deaths by overdose or suicide, Waller told the crowd: 性视界传媒淭hose are lives that still deserve to be among us.性视界传媒�

Robert Williams, the local性视界传媒檚 business manager and secretary-treasurer, described what he called a familiar scenario: A worker experiences a jobsite injury or persistent soreness, feels pressure to work through it, then escalates from an over-the-counter pill to a prescription painkiller to an illicit opioid addiction.

性视界传媒淲e性视界传媒檙e only with our families a small portion of the day,性视界传媒� he said. 性视界传媒淭he people we work with, we性视界传媒檙e with 80% of the time. We性视界传媒檝e got to be open on those job sites.性视界传媒�

The union and local employers realized they had a problem on their hands last summer. After sifting through their health plan records, they found 91 members had died of overdose or suicide (not necessarily at work) in 18 months.

The revelation forced union officials to rethink their roles in workers性视界传媒� lives, Williams said in an interview.

性视界传媒淲e look out for safety on the jobs, so if there性视界传媒檚 a death on a job site because of a safety hazard, it性视界传媒檚 front-page news,性视界传媒� he said. 性视界传媒淏ut if there性视界传媒檚 death by an overdose or death by suicide of a construction worker when they go home, nobody talks about that. So instead of thinking about just the safety side, it性视界传媒檚 that holistic side of, how do we make somebody better for themselves and their families?性视界传媒�

Williams quickly appointed a director of addiction and mental health. James Boster, himself in recovery from a painkiller addiction he said he developed after a non-work injury, speaks at apprenticeship programs and worksites, helps workers get into recovery programs and acts as a crisis counselor.

In the past year, Boster said he性视界传媒檚 helped place 51 union members into residential or outpatient treatment programs. During a recent interview at the union性视界传媒檚 headquarters in Livermore, he said he was anxious: He had secured a 性视界传媒渟cholarship性视界传媒� for one member who hadn性视界传媒檛 logged enough hours in recent months to have full health coverage, but the worker had chosen to postpone treatment.

性视界传媒淚 can never walk away from a member, and something happens, and not hold that personally,性视界传媒� Boster said.

Boster and Williams are eager to expand their program. Ideas include installing someone with Boster性视界传媒檚 role across the district性视界传媒檚 20 local unions and establishing a fund to help members who haven性视界传媒檛 worked enough hours to afford treatment.

Other advocates, meanwhile, have pushed the state to require naloxone at worksites as part of an overall strategy to reduce overdoses.

Earlier this year, the National Safety Council, an advocacy group, petitioned California labor agencies to do just that. Proponents said the medication, which can temporarily reverse an overdose by blocking the brain性视界传媒檚 opioid receptors, is easy to administer and not harmful.

Citing its workplace death data, Cal/OSHA supported the proposal before the independent Occupational Safety & Health Standards Board, which decides whether to approve such regulations.

性视界传媒淚t性视界传媒檚 in the top two or three killers of workers now, and just a few years ago, it was a very small number,性视界传媒� Eric Berg, Cal/OSHA deputy chief of health and research and standards, said at a June 20 board meeting. 性视界传媒淪o it性视界传媒檚 just become a really serious problem for workers, and it性视界传媒檚 killing workers. I think we have an obligation to act.性视界传媒�

But board members hesitated. Chairperson David Alioto called the proposal an 性视界传媒渙dd request.性视界传媒� While addiction is a legitimate public health concern, it性视界传媒檚 not a workplace hazard like wildfire smoke for employees who must work outside, he said.

性视界传媒淚 have not seen a regulation where an employer is providing a remedy for a risk that the employer did not create,性视界传媒� Alioto said.

Board members also said they worried about whether all businesses would be able to store the medication at the right temperature, and whether employers would bear liability over the medication性视界传媒檚 use.

The standards board ultimately voted for the agency to discuss the matter before an advisory committee. In September, Gov. Gavin Newsom signed a law directing Cal/OSHA to draft a workplace naloxone rule by December 2027 and giving the board until December 2028 to consider it. So far, no advisory committee has met.