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Why the Opioid Crisis Matters to Contractors (and your families) in the Carolinas

by Cal Beyer, CWP on

The opioid crisis has plagued the nation since the late 1990s. Overdose deaths have been rising year after year. Nationally, the Centers for Disease Control and Prevention (CDC) reported 107,699 overdose deaths in 2022 (KFF). Seventy five percent of all overdose deaths nationally are attributable to opioids. The figures are higher in both North Carolina and South Carolina at 84 percent and 80 percent, respectively. 

State2022 All Drug Overdoses2022 All Opioid Overdoses2022 Opioid Overdose Rate (age-adjusted) – per 100,0002022 All-Drug Overdose Rate  (age-adjusted) – per 100,000
US Overall107,69981,05124.832.5
NC4,0953,44734.340.3
SC2,2781,81236.745.3
  Source: KFF 2022 provisional data

Nationally in 2021, approximately 72.7 percent of all overdose deaths were attributable to the lethal synthetic opioid fentanyl. The concentration of fentanyl-related deaths were higher in both North Carolina and South Carolina at 88.9 percent and 83.1 percent, respectively.

The rate of opioid prescription dispensing rates is declining nationally and now stands at 39.5 per 100 of population. The rates are also declining in both North Carolina and South Carolina yet remain above the national threshold: 48.9 per 100 residents in North Carolina and 51.5 in South Carolina. Naloxone/Narcan dispensing rates continue to be at 0.5 per 100 of population nationally. North Carolina is at the national rate whereas South Carolina is double at 1 per 100.  

How Construction Is Impacted Hard by Opioids and Overdose Deaths

On August 22, 2023, the CDC in National Vital Statistics Report showing overdose deaths by industry or occupation for 2020. This data was not broken down by state. Construction and Extraction was shown to have the highest rate with 162 deaths per 100,000 workers. For the construction industry alone, the rate was 130.9 per 100,000 workers.

Here is why this matters:

  1. Overdose deaths inflict a toll on families, workplaces, communities, and the state economies. Parents, grandparents and every person connected to children and young adults must learn the risks of fentanyl.
  • Year after year, a portion of working aged adults and youth is lost to overdoses. The opioid crisis has shrunk the possible workforce candidate pool for industries like construction, manufacturing and agriculture.   For the US, males account for 71% and females comprise 29% of the overdose deaths. In the Carolinas the figures track closely with the national rates by gender with a 70-30 split in North Carolina and 69-31 in South Carolina.  
  • Nationally, the age group most affected by overdoses is those aged between 25-44 years. Overdose deaths in North Carolina are more concentrated in the under 45 year age ranges than nationally and in South Carolina. In North Carolina, 67% of overdose deaths are under 45 years of age compared to 61% in South Carolina and 59% nationally.
Age Group< 24 years25-3435-4445-5455+
Percent in US8%25%26%19%21%
Percent in NC9%30%28%19%14%
Percent in SC9%26%26%21%18%
Source: KFF data for 2021.
  • Prescription medications are a potential source of new persistent opioid use in construction, especially relating to musculoskeletal injuries. “In Waging a Counterattack Against Opioids in the Workplace and at Home,” the increased frequency of opioid prescriptions among construction workers is highlighted. Moreover, prescription doses tend to be 20% stronger and for 20% longer durations. This article highlights eight First-Dose Prevention Strategies to decrease the risk of opioids at home and in the workplace.
  • Surgery is a leading gateway to new persistent opioid use. An article in Insurance Thought Leadership titled “Optimizing Surgical Outcomes” highlighted that between 8-18% of patients are affected depending on the type of surgery. Opioid-sparing Enhanced Recovery After Surgery (ERAS) protocols use up to 90% less opioids than conventional surgical methods.
    • It is imperative for employees and dependents enrolled in contractor health benefit programs to know non-opioid medications exist.
    • Multi-modal pain relief can be more effective at controlling post-surgical pain than opioids and without the risk of addiction.
    • Become informed and be an advocate for yourself or any other family member scheduled for any medical, surgical, or dental procedures.
  • Drug deactivation products help properly dispose of leftover opioid pills after prescriptions for on- and off-the-job injuries and surgeries. Research shows 90% of patients receiving pain medication do not properly dispose of the leftover pills. This increases the household risk of overdose deaths due to the diversion of the leftover pills.

Conclusion

Opioids impact every socioeconomic class and demographic status. Opioids are an equal opportunity destroyer of hope and lives. The construction and aggregates industries have been hit hard by opioids due to the high frequency of musculoskeletal injuries. Employers are encouraged to teach employees about the risks of opioids and to share resources to help employees and families protect themselves from opioids.

Photo Credit: Image (at top of page) was used with the permission of SAFE Project.

Cal Beyer, CWP is a long-time national advocate for workplace mental health, substance misuse, suicide prevention, and opioid risk reduction and overdose prevention. This grew out of his work on human capital risk management and worker well-being. He is a strategic partner with SAFE Project (Stop the Addiction Fatality Epidemic). He serves on the Executive Committee of the National Action Alliance for Suicide Prevention, and advisory boards for the Suicide Prevention Resource Center, Goldfinch Health, MindWise Innovations, and Youturn Health. Beyer can be reached at cal.beyer@gmail.com or 651.307.7883.

Cal Beyer

Resources:

Beyer, Cal, and Newland, Brand. (October 10, 2021). Optimizing Surgical Outcomes. Insurance Thought Leadership. https://www.insurancethoughtleadership.com/life-health/optimizing-surgical-outcomes 

Beyer, Cal., Jones, Richard., and Newland, Brand. (April/May 2022). Waging a Counterattack on Opioids in the Workplace and at Home. Construction Financial Management Association. (CFMA). Building Profits. https://cfma.org/files/o-files/view-file/7eb2bd81-7ccf-46b3-a3b6-aa71aa7dbfb1 

Billock RM, Steege AL, Miniño A. (August 22, 2023). Drug overdose mortality by usual occupation and industry: 46 U.S. States and New York City, 2020. National Vital Statistics Reports; vol 72, no 7. Hyattsville, MD: National Center for Health Statistics. 2023. https://www.cdc.gov/nchs/data/nvsr/nvsr72/nvsr72-07.pdf 

Centers for Disease Prevention and Control (CDC). (December 11, 2023). U.S. State Opioid Dispensing Rates. https://www.cdc.gov/drugoverdose/rxrate-maps/index.html 

KFF. State Health Facts. More than 800 up-to-date health indicators at the state level can be mapped, ranked, and downloaded. Search opioid overdoses by state. https://www.kff.org/statedata/