ODPRN research finds construction and trades workers made up a third of Ontario's opioid deaths with known jobs
Construction and trades workers accounted for roughly one in three Ontario opioid toxicity deaths where the person's occupation was known between 2018 and 2024, according to a new report from the Ontario Drug Policy Research Network (ODPRN). The finding confirms a pattern the research group first identified in a smaller 2022 study, and adds fresh detail on how the crisis touches other sectors.
The report, titled Circumstances Surrounding Opioid Toxicity Deaths Across Occupational Sectors in Ontario, 2018 to 2024, drew on population-based health data from ICES, a non-profit health data research institute, and covered nearly 16,000 opioid deaths across the province. The investigating coroner recorded an occupation in only about 22 per cent of those cases, roughly 1,340 of whom worked in construction or the trades.
Construction and trades workers died from opioid toxicity at a rate of 54.5 per 100,000 in 2024, the report found, far outpacing natural resources and agriculture workers, at roughly 32 per 100,000, and hospitality workers, at 8.9 per 100,000. Manufacturing, hospitality and retail workers each made up close to 10 per cent of deaths with a known occupation.
"People across every walk of life and every kind of job are affected by opioid toxicity," said Shaleesa Ledlie, senior research associate at ODPRN and the study's lead author.
Long shifts and stigma drive opioid risk in construction
In an interview with Canadian Occupational Safety, Tara Gomes, principal investigator at ODPRN and a professor at the University of Toronto, said the new report builds on work her team began early in the pandemic after hearing from community members about specific substance use patterns in construction.
She said 96 per cent of the deaths in the sector were among men, and more than 90 per cent were accidental. Half involved cocaine and a quarter involved methamphetamines, a pattern Gomes linked to workers using stimulants to stay alert through long shifts or to counteract the sedating effects of opioids in safety-sensitive roles.
"We know that people are more often likely to experience injuries, but there are structural barriers to actually talking about your injuries, your pain, or how that might translate to you using opioids to try and manage that pain," Gomes said. "That can increase people's risk of hiding substance use and potential harms."
Strict policies can backfire
Gomes cautioned that Ontario's mandatory naloxone kit requirements for construction employers and abstinence-based drug policies, while well-intentioned, can push workers toward the unregulated drug supply rather than disclosing pain or substance use.
"People who rely on those jobs and positions to put food on the table and to support their family are then more likely to hide their substance use or hide their pain and even use the unregulated illicit opioid supply to manage that pain," she said, adding that the resulting stigma connects directly to the construction sector's broader mental health and suicide prevention challenges.
Gomes noted most overdoses happen at home rather than on site, which she said can lead employers to view the issue as separate from the workplace. On naloxone specifically, she said: "My perspective is naloxone should be everywhere." She added that on-site kits alone have limited reach given where overdoses actually occur, "but any one life saved is an important life to save."
Her team is now examining healthcare encounters, including recent workplace injuries and opioid prescriptions, in the months before death, hoping to identify missed opportunities for intervention. The pattern itself is not new: our previous coverage of the initial 2022 construction opioid death findings showed construction workers accounted for nearly one in 13 opioid deaths recorded between 2017 and 2020, a smaller but consistent share of a crisis researchers say has only deepened since.
