Should workplaces stock the overdose reversal medication naloxone? Why some advocates say yes
Some companies add overdose reversal medication to first aid kits as construction workers face the highest death rates
(InvestigateTV) — The opioid crisis has held America in its grip for decades, but signs of improvement are starting to show.
Data from the U.S. Centers for Disease Control & Prevention revealed about 30,000 fewer overdose deaths in 2024 compared to 2023.
- 2023 Deaths = 110,037
- 2024 Deaths = 80,391
- Decrease of 26.9%
While there’s no single known reason for that reduction, many experts believe increased availability of naloxone, also known as Narcan, is a big factor. The medication can rapidly reverse an overdose from opioids such as fentanyl, heroin and prescription pills.
In March 2023, the FDA approved naloxone for over-the-counter use.
Since then, schools, libraries, public transit and some airplanes have begun stocking it.
Now there’s a push to expand access further by adding naloxone to first aid kits in the workplace.
Construction industry faces highest overdose rates
According to a CDC report published in 2023, construction has the highest death rate from drug overdose when compared to other occupations. The latest available numbers from 2020 show more than 162 overdose deaths per 100,000 construction workers.
“Overdose is a national epidemic right now. Specifically in the construction population,” said Dan Blankfeld, vice president of safety for CBG Building Company in Maryland.
Chris Trahan Cain leads the Center for Construction Research and Training, where they’ve been tracking this trend for years.
“It’s absolutely unacceptable,” Cain said. “It is very clear that there’s contributing factors from our industry.”
She cited precarious employment as one factor. Construction workers often work through pain because taking time off means no pay, leading to prescription pain medication use.
“You are talking about precarious employment. If you work in an office and you turn your ankle, you can take a slow day at home and elevate, ice and rest. If you do that and you’re a construction worker, you don’t get paid. So there’s a real push to work through pain,” Cain said.
Pushing through the pain oftentimes involves prescription pain medications, she said.
“So what happens when you cannot fill your prescription or something interrupts that? We know that’s one of the paths towards a substance use disorder and the use of illicit drugs,” Cain said.
Union leader witnesses devastating losses
Brendan Loftus built a career with the International Union of Elevator Construction in New York City and has seen how that cycle can turn deadly.
“I heard that story over and over and over,” Loftus said. “It was at the height of the fentanyl crisis. We had five overdoses and five overdoses of young men all under the age of 30.”
Five lives and five co-workers were lost to overdose in less than 11 months.
“I went to every single wake. To watch mothers bury their sons at such a young age, it was devastating, and it was alarming to us,” Loftus said.
Loftus, who has been clean and sober for more than two decades, started an addiction services support program he now leads on behalf of his union. He works to educate employees on the front end, as well as helping to get them treatment or rehab when needed.
“I think we have a responsibility to help our members,” Loftus said.
Loftus also believes the overdose reversal medication naloxone goes hand-in-hand with those efforts.
“I’ve heard stories of people collapsing on job sites and given Narcan and come back and gotten a second chance at life. Every company gives them a safety bag. You have your harness and your hard hat and your safety glasses, we want Narcan in those bags. We think it prevents people from dying. So, there’s a big push, I think, throughout the country,” Loftus said.
Workplace overdose deaths climb nationwide
“I don’t think a lot of folks realize that about 10% of workplace deaths are actually due to overdose on the job,” said Claire Bryant of the National Safety Council.
The organization points to data from the U.S. Bureau of Labor Statistics that shows workplace deaths due to unintentional overdose climbed for ten straight years, from 2012 to 2022, with a slight decrease to 512 overdose deaths in 2023.
“So, just like you would have an AED or first aid kit for any other potential concern or injury, or emergency in the workplace, the same concept applies to Naloxone. It’s just one more tool in the toolbox, which is really critical for safety,” Bryant said.
Recent developments and remaining challenges
In 2024, Amazon announced it would begin stocking naloxone at the company’s warehouses nationwide.
California became the first state to move toward requiring naloxone in the workplace when Assembly Bill 1976 was signed into law, directing the state’s Occupational Safety and Health Standards Board to begin the process to revise existing regulations.
An NSC survey of more than 500 employers found 50% were currently stocking naloxone, while 27% were considering it, 6% were opposed to it and 17% had little or no knowledge about what it is.
“I would say the primary challenge to expanding Naloxone access is stigma,” said Dr. Kristin Schneider of the Johns Hopkins Bloomberg School of Public Health.
“There’s also this misperception that naloxone is enabling to people who use drugs, but there’s no good scientific evidence indicating that is in fact the case,” Schneider said.
She noted that if naloxone is administered to someone who doesn’t have opioids in their system, it will do no harm.
“Having those tools available, the worst-case scenario is you save someone’s life. I don’t see downsides to having naloxone in the workplace,” Schneider said.
Companies implement training programs
CBG Building Company in Maryland now includes a naloxone class as part of orientation for every new hire in response to overdose concerns in construction. The medication is always stocked in their first aid kit, and two additional doses are supplied to each worker.
“It’s the same reason we wear hard hats, safety vests, and specific personal protective equipment on a job site. It’s the same reason why we put fire extinguishers every 50 feet,” Blankfeld said. “We have to find a way to protect the workers, sometimes from themselves. So, this is lifesaving.”
“Of course, the most common thing that protects those who try to render aid to another person are Good Samaritan laws. And most of our states, and even more refined in specific counties or metropolitan areas, have laws that protect people who try to save the life of another,” said Jim Link, SHRM chief human resources officer.
SHRM recommends employers establish specific policies and procedures for naloxone programs, including who calls 911 and when, who administers the naloxone, and training employees to recognize signs of overdose.
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