Laborers — particularly those in construction — are more likely to die from opioid overdoses than people in other professions, raising questions about equal access to treatment and the path to addiction for those in physically demanding jobs.
The drug epidemic has cut a swath through both the working and upper classes in Ohio, but construction workers are particularly hard hit, according to new data from the Ohio Department of Health.
The data includes information on the professions of those who died of opioid overdoses from 2010 to 2016 — from dishwashers to doctors, CEOs to cops.
Taking into account the number of people in each profession statewide, construction workers were seven times more likely to succumb to a fatal overdose of pills, heroin or fentanyl than the average worker.
“It’s just a tough business,” said Dennis Duffey, secretary treasurer of the Ohio State Building and Construction Trades Council.
People work through injuries that cause them to turn to pain killers, Duffey said, adding: “I can understand how guys can get pulled into (addiction).”
Unlike some professions, which have specifically tailored programs to help them through rehab without sacrificing their license or their job, most laborers don’t have that benefit. Construction contracts often don’t include sick days, though some union health plans have provisions for covering short-term disability to go to rehab.
The data is culled from information provided by families on death certificates. It was originally obtained from the state health department by the (Cleveland) Plain Dealer, which then shared it with other media outlets.
Not every fatal overdose victim — more than 12,600 in seven years — had an occupation listed. More than 1,600 people had their occupation listed as unknown while hundreds listed disabled, unemployed or homemaker. It’s also likely that in some cases the occupation listed was the last one the person had before becoming unable to work, perhaps due to addiction or injury.
Despite its limitations, the data shines a bright spotlight on the industries hardest hit by the opioid crisis. After construction work, the farming, fishing and forestry industry — a small category in Ohio with just 4,000 workers statewide, according to the Bureau of Labor Statistics — had the second highest rate of overdose deaths in 2016 at 23.92 per 10,000 workers.
In third place was building and grounds cleaning and maintenance — a job classification that includes tree trimming.
Charles Rollins of Springfield, a recovering addict who now runs a tree-trimming business employing others in recovery, isn’t surprised at the high ranking.
“These kinds of workers are a dime a dozen,” he said, arguing that employers don’t want to invest in drug education and treatment programs for non-skilled workers when they can get someone else to do the work. “They’re expendable.”
Ripe for addiction
Rollins started a recovery housing non-profit, Gemini Reliance, with his twin brother after getting out of prison in 2013. That’s when he noticed that a majority of the men living in the houses were working as tree trimmers.
The main factor that makes tree-trimming a job ripe for addiction, Rollins said, is the culture of how workers get paid, usually in cash, by the day.
Rollins said he runs a clean business with the aim of helping those in recovery stay clean, but he said there are a lot of unscrupulous business owners.
“It’s slave labor,” he said of how some work crews are run.
Staying clean is a life-long battle, which Rollins knows from personal and painful experience.
His brother Mike was clean for seven years after also serving prison time, according to Charles Rollins. But when he broke some ribs, he was prescribed opioids and went back to using, hiding it from his family until his death from an overdose in September.
His obituary was unique in its frankness, saying, “Michael Shane Rollins Sr., 41, of Springfield, passed away of an overdose of heroin.”
‘Death doesn’t care who it takes’
Not everyone who dies from opioid overdose has a long history of battling addiction.
Emily Stokesbury’s brother, Bradley was a hard worker who hadn’t yet found his dream career. The 20-year-old went to work every day from 8 a.m. to 5 p.m. at Ratliff Metal Spinning, where he worked in shipping and receiving. He lived at home in Riverside, liked to fish, and — like most young people — hung out with his friends on the weekends.
One weekend in March 2016, Stokesbury was drinking with friends and took what he thought was a Xanax pill, according to his sister. He died several days later after being in a coma from an overdose of fentanyl.
In the aftermath of her brother’s death, Emily Stokesbury said many people were quick to assume he was junkie who’d been hooked on heroin.
“I just think there is a bad stigma,” she said. “This was obviously an accident. It could happen to anyone.”
Brad Stokesbury hadn’t been in and out of rehab. He’d never been revived with Narcan. His only brush with the law had been eight months before his death when he was caught breaking into a shed. He was given treatment in lieu of conviction.
Emily hopes stories like her brother’s will help people see that opioid use is happening in every community and could impact any family, including doctors, lawyers and CEOs.
“Death doesn’t care who it takes,” she said.
The data shows there are doctors, lawyers and CEOs who die from opioids, but they die at a much lower rate than heavy laborers, such as roofers, construction workers and tree-trimmers.
Yet doctors become addicted to drugs or alcohol at a slightly higher rate than the general population, according to the National Institutes of Health, which found the addiction rate among doctors to be more than one in 10. Burnout and availability of drugs are cited as causes.
Doctors who become addicted have an advantage over those in the working trades, however. They have vastly more resources available to them.
Nearly all states, including Ohio, allow doctors to complete specialized treatment plans rather than lose their license because of a mental health condition, drug or alcohol addiction, or both. The Ohio Physicians Health Program is a non-profit that offers referrals to treatment and facilitates “monitoring agreements” where doctors voluntarily agree to follow treatment recommendations in lieu of consequences like losing their license.
A similar program for lawyers is called the Ohio Lawyers Assistance Program.
In the 1970s, so many lawyers were having issues with alcoholism that a group of recovering alcoholic lawyers began what was then a volunteer group to help their co-workers get sober. That morphed into the more formal non-profit that is now funded through the dues lawyers pay to the Ohio State Bar Association and the Ohio Supreme Court’s Attorney Services Fund.
“Our goal is to stop the down escalator before it hits the bottom floor,” said Scott Mote, executive director of the program and a recovering alcoholic and lawyer. “What our experience has been is that 90 percent of the people with whom we work stick with it.”
‘A critical issue’
There is no similar, statewide program for laborers, but more attention is getting focused on helping those in the building trades with drug problems.
The Bureau of Workers’ Compensation requires any construction company bidding for government work must implement a drug-free workplace program. Such programs require a one-time, one-hour training for employees on drugs and alcohol, requires employers do random drug testing. It also requires the employer to make a list of employee assistance vendors available to employees.
The National Association of Building Trades Unions (NABTU) is working to address opioid addiction in their industry, Communications Director Tom Owens said.
”We acknowledge that this is a critical issue facing our unions and our contractor and end-user partners, and we are being proactive towards addressing the situation,” Owns said in a statement.
NABTU plans to convene a round-table discussion in January to develop effective education and treatment protocols for their members who suffer from this addiction, he said.
Part of addressing the problem needs to involve changes to prescribing guidelines, according to Scott Weidle, founder of DanielsStory.org in honor of his son who died of a heroin overdose in 2015.
Daniel Weidle, 30, of Germantown, worked as a construction laborer. He’d been through several treatment programs and had found success with taking Vivitrol, a monthly injection that blocks the receptors that make addicts crave opioids.
But when the health care provider went out of business, he lost access to that treatment and relapsed, according to his father.
Scott Weidle drafted Daniel’s Law, now House Bill 167, which would codify Governor John Kasich’s order limiting the amount of opioids a primary care doctor can prescribe.
“If the construction industry has the highest rate (of overdose death)… they didn’t get hurt and go to the street corner for their broken rib,” Scott Weidle said. “They went to their doctor.”