While unintentional workplace overdose deaths involving drugs or alcohol have surged by over 460 percent since 2011, recent figures show encouraging signs of progress. Among construction workers aged 16–64, drug-related overdose deaths fell by 28.8 percent between 2023 and 2024, dropping from 15,900 to 11,300. This substantial decline suggests that targeted interventions are successfully reaching those in need.
“The recent drop in overdose fatalities demonstrates that purposeful action can lead to significant transformation in our industry,” said LIUNA General President and LHSFNA Labor Co-Chairman Brent Booker. “To continue this progress, we need continued investment in mental health support, stronger leadership involvement and a jobsite culture that values mental health as much as physical safety.”
Recent improvements are not accidental; they are the result of coordinated, sustained efforts across the industry. Construction trade unions, associations, alliances and research organizations have worked collaboratively to better understand the root causes of substance use and mental health challenges and to implement practical solutions. Key contributions to these rates decreasing include:
These combined efforts are important because they show that change is possible when the industry works together. By focusing on awareness, early intervention and support, we can all help workers get the help they need before problems become more serious.
The LHSFNA has played a critical role in advancing these efforts. Through initiatives such as Laborers Escaping Adversity Now (LEAN LIUNA) and Blueprint for Balance (B4B), LIUNA members are provided with tools and resources to support both physical and mental well-being on and off the jobsite. Additionally, collaboration with industry alliances, associations and roundtables ensures that best practices are continuously shared and improved upon.
A critical component of maintaining this progress is recognizing the construction worker’s dual burden of physical and psychological stress; chronic pain is found at the root of both. While it’s well-established that construction workers experience psychological stress due to job insecurity, demanding hours, workplace bullying and high production pressures, there is also a powerful link between physical injury and mental health. Chronic pain can contribute to elevated levels of stress, anxiety and depression. Sometimes, experiencing (or even witnessing) serious injuries can also cause long-term psychological issues, such as post-traumatic stress disorder.
Chronic pain is also one of the primary drivers behind the use of prescription pain medications in construction. The pressure to work through the pain and avoid lost wages often pushes workers toward quick pain relief solutions that carry long-term risks, such as addiction or dependence. Research shows that workers diagnosed with musculoskeletal disorders (MSDs) are more than four times more likely to develop an opioid use disorder than those who started opioids for other diagnoses. A strong focus on injury prevention plays a crucial role in continuing to reduce the overdose death rate in construction.
The LHSFNA researches and promotes strategies to reduce musculoskeletal injuries, such as improving work environments, better task planning and the using innovative technologies such as exoskeletons. These devices are designed to reduce strain during repetitive or physically demanding tasks, which can help minimize fatigue and lower the risk of injury over time. Additionally, the Fund researches and promotes non-drug approaches to managing pain like chiropractic care, acupuncture and yoga.
Reducing the physical strain of construction work can lower the need for pain medications and help address one cause of substance use. Even though construction is still a high-risk industry, the recent drop in overdose and suicide rates shows that progress is possible. To keep improving, the industry must continue focusing on safety, health education, mental health support and preventing injuries. In the end, protecting construction workers means caring for their physical and mental well-being every day.
[Ryan Papariello]
