Breaking the Silence on Addiction in Construction
Construction workers account for 15% of workplace overdose fatalities in the U.S. — a staggering number that highlights the urgent need for awareness and action during National Recovery Month this September. Research shows construction employees are nearly twice as likely as the general workforce to struggle with substance use disorders. Approximately 15% of construction workers face a substance use disorder, compared to 8.6% of adults nationwide.
The risks extend beyond opioids: more than 16% of construction workers report heavy alcohol use in a single month, while over 11% report illicit drug use in the same time frame. Nearly 12% struggle with alcohol use disorder specifically, and more than 14% have been diagnosed with a substance use disorder in the past year.
Mental health also plays a major role. One in five construction workers experience anxiety, depression, or other mental health challenges. In a profession that prizes toughness and endurance, stigma can prevent workers from seeking the help they need.
A recent study of unionized construction workers found that job-related injuries often serve as a gateway to dependency, particularly when pain management relies heavily on opioids. But as experts stress, that path is preventable when workers receive the right treatment, support, and resources.
To dig deeper into the issue, Dr. Nzinga Harrison, Chief Medical Officer at Eleanor Health, an online rehab program for alcohol and drug addiction, shared her perspective on why the construction workforce is at heightened risk, and how employers, unions and healthcare providers can respond with compassion and effective strategies.
Dr. Nzinga HarrisonNzinga Harrison MD
Q: Why are construction workers disproportionately impacted by substance use and overdose compared to other industries?
Harrison: Construction has one of the highest rates of workplace injuries, and opioids are often prescribed for pain. Combine that with long hours, job insecurity, and a culture that prizes toughness, and the risk for substance use and overdose skyrockets. In short, when injury, pain, and a “tough it out” culture collide, the risk for addiction goes up.
Q: The recent study shows job-related injuries can spark a path toward dependency. How does that process often unfold?
Harrison: It usually starts with a legitimate prescription after an injury. If pain lingers or the worker feels pressure to get back on the job, reliance on opioids can last longer than intended and gradually lead to dependence. It’s important for people to understand before getting the first opioid prescription that pain relief can quietly become a pathway to addiction.
Q: Stigma remains a major barrier to getting help. What misconceptions need to be broken down?
Harrison: Addiction is often viewed as a moral failing, when it’s actually a medical condition influenced by brain chemistry and environment. Reframing it as a health issue helps replace stigma with support in the workplace. Also, many people think there is no hope for addiction, when in fact, 75% of people who have experienced addiction are in recovery. Addiction isn’t a weakness, it’s a health condition — and people recover every day.
Q: What are some early red flags supervisors, colleagues, or even workers themselves should watch for?
Harrison: Changes in attendance, declining performance, or safety lapses can be early signs. Colleagues might notice withdrawal, mood swings, or a drop in reliability. These should be signals that someone needs support, not punishment.
Q: From a prevention standpoint, what practical steps can employers take?
Harrison: Preventing injuries is the first line of defense. Beyond that, employers can provide mental health resources, confidential support, and training for supervisors to recognize concerns early. Most importantly, workers need to feel safe asking for help.
Q: What workplace policies or assistance programs are most effective?
Harrison: The most effective programs combine confidentiality, ease of access, and real pathways to care. Leadership has to actively champion these programs, and workers must trust they won’t face retaliation for using them.
Q: How do mental health challenges intersect with substance use in construction?
Harrison: Up to 80% of people with substance use disorders also have another mental health condition, most commonly depression or anxiety. Stress, anxiety, and depression are common in construction and can drive unhealthy coping. Without support, workers may self-medicate with substances, fueling a cycle of worsening health.
Q: How can employers, unions, and healthcare providers reduce dependency risks during recovery from an injury?
Harrison: Employers can prioritize safer return-to-work policies and avoid pressuring workers into quick fixes with opioids. Unions can push for strong safety standards and worker resources. Healthcare providers can prescribe responsibly and emphasize non-opioid treatments. When all three pull in the same direction, workers heal without falling into addiction.
Q: For a worker in recovery, what role can employers and coworkers play?
Harrison: Respect and inclusion are critical. Workers thrive when treated like valued team members, not liabilities. Flexibility for treatment and encouragement from colleagues make recovery sustainable. Celebrate not just those in recovery, but also those who seek support.
Q: What gives you hope about changing the culture around addiction and recovery?
Harrison: I see more leaders openly acknowledging addiction and pushing for solutions. The national conversation is shifting from blame to compassion. Every open conversation chips away at stigma and saves lives.
Q: Is there anything else you’d like to share?
Harrison: Addiction affects every industry, but construction has a unique opportunity to lead the way in workplace safety and recovery support. Taking action now means healthier workers, safer job sites, and stronger communities.
Resources for the Industry
Industry initiatives are helping break down barriers and spark conversations. Construction Safety Week offers a Mental Wellness Field Guide designed to help teams strengthen mental health awareness and connect workers to appropriate professional support.
Additional resources, including national treatment and recovery programs, are available through the Substance Abuse and Mental Health Services Administration (SAMHSA).
A Call to Action
As the construction industry continues to face workforce challenges, addressing addiction and mental health is not only a moral responsibility but also a safety priority. By replacing stigma with compassion and making support accessible, employers, unions, and coworkers can save lives — and ensure that construction remains a place where people can build both careers and healthy futures.
