Ep.22 - The Overdose Crisis in Construction

Construction has the highest opioid death rate of any industry in Ontario, more than four times the next sector. A new ODPRN report tracked 1,338 opioid deaths among construction and trades workers between 2018 and 2024, and flags that the true number is likely much higher due to missing occupation data. In this solo episode, Angelo breaks down how the industry’s injury rates, prescribing patterns, and toughness culture combined to produce this crisis, and lays out a concrete, unglamorous list of what leaders can do this week to change it.

Key topics covered

• Ontario’s construction and trades opioid death toll: 1,338 people, 37.9% of deaths with known occupation, 2018–2024

• Why the recorded number is a floor: nearly 8 in 10 deaths in the dataset have no occupation on record

• Where and how these deaths actually happen: 77% alone, 75% in a private residence, only 47% employed at time of death

• The injury-to-prescription-to-fentanyl pipeline, and why 90% of construction firms are too small to manage it alone

• Toughness culture as a psychological safety failure, and its link to elevated suicide rates in the trades

• What’s working: a 28.8% one-year drop in the U.S. construction overdose rate (2023–2024)

• A leader’s practical to-do list: naloxone access, EAP awareness, changing how pain and time off get talked about, staying connected after layoffs

Sources referenced

• ODPRN, Circumstances Surrounding Opioid Toxicity Deaths Across Occupational Sectors in Ontario, 2018–2024

• CDC / National Vital Statistics System, 2020 occupational overdose data

• CPWR (Center for Construction Research and Training) opioid research

If you need support

In Canada or the US, call or text 988 any time. In Ontario, you can also reach the Mental Health and Addictions line at 1-866-531-2600.