Opioid Overdose Deaths
More Likely Among Massachusetts Residents Injured at Work, New Department of
Public Health Report Finds
Workers in construction
and other physically demanding industries disproportionately impacted
BOSTON (May 23, 2024) –
Working-age Massachusetts residents who died between 2011 and 2020 were 35
percent more likely to have died of an opioid-related overdose if they had
previously been injured at work, according to a new report released today by
the Massachusetts Department of Public Health (DPH) that, for the first time,
links the aftermath of work-related injuries to opioid-related overdose deaths.
Using the Public Health Data Warehouse, DPH compiled
information about individuals’ employment and work-related injury status from
their workers’ compensation claims and linked it with data from their death
certificates. By linking these data sets, DPH found that of the 4,304
working-age (16-64 years) Massachusetts residents who died and had at least one
workplace injury claim, 741 (17.2 percent) died from an opioid-related overdose
between 2011 and 2020. Previous analyses primarily relied on death certificate
data, which have limited work-related information.
The data also show that
injured workers who died from an opioid-related overdose were more likely to be
male, between 25-44 years old, Hispanic, US-born, and have jobs in construction
and extraction (e.g., quarrying and mining), as well as in food preparation and
serving, compared with those who died of causes unrelated to substance use.
Sprains and strains, particularly of the back, were the most common injury
types among those who suffered fatal opioid-related overdoses – a significant
finding that allows DPH to, for the first time, assess the correlation between
acute and chronic pain from occupational injuries and opioid use and death.
“Occupational injuries
can take both a physical and mental toll, and those who suffer injuries at work
may be discouraged from seeking help because of stigmatization and fear of
losing their jobs. Avoiding or delaying care can lead to a preventable overdose
death,” said Secretary of Health and Human Services Kate
Walsh. “In order for us to properly address the overdose crisis, we must
eliminate the stigma that accompanies substance use disorder in all sectors of
society, including the workplace. We are prioritizing investments in community
support, prevention, and treatment programs and reducing any barriers to
treatment, all of which can help prevent overdose deaths.”
“Overdose deaths are
preventable, and we must continue to focus relentlessly on finding ways to
prevent opioid addiction from stealing more lives,” said Department
of Public Health Commissioner Robbie Goldstein, MD, PhD. “The data are
clear: Individuals who suffer work-related injuries are at a heightened risk of
substance use disorders – and overdose deaths. By recognizing and acting upon
this association, we can target interventions that can save lives and protect
the well-being of workers, especially those in physically demanding occupations
who are disproportionately affected by the opioid epidemic.”
Workers in industries
and occupations that require very physically demanding work and who have much
higher rates of overall workplace injury than other workers continue to be
disproportionately affected by the opioid epidemic, according to the report, which
was created by DPH’s Occupational Health Surveillance Program. The majority
(28.2 percent) of the 741 Massachusetts workers who were previously injured at
work and who died of an opioid-related overdose between 2011 and 2020 worked in
construction and extraction occupations, according to the data. This is
followed by 11.2 percent who worked in transportation and material-moving, and
6.8 percent who worked in food preparation and serving-related occupations.
Work-related factors,
such as lower rates of paid sick leave, low wages, and higher job insecurity
(e.g., seasonal work, independent contractors, and temporary help), exacerbate
the pressure on workers to work while ill or injured, and not seek crucial medical
or substance use treatment for fear of losing income.
While the data indicate
there were lower numbers of deaths among residents of color who were injured at
work compared with white non-Hispanics, who made up the majority of the state’s
workforce in 2011-2020, Hispanic workers in Massachusetts suffer the highest
rate of death from
workplace injury. Nationwide, both Hispanic and Black non-Hispanic workers
disproportionately work in the most dangerous jobs that can lead to injury.
This report may not
represent the full picture of injured workers who died from an opioid-related
overdose in Massachusetts. The data do not include workers who were injured on
the job but who did not file a workers’ compensation claim. This cohort may include
immigrant and undocumented workers who may be less likely to file a workers’
compensation claim or may experience barriers to filing one.
DPH continues to support
worker-focused efforts that involve the expansion of prevention, intervention,
treatment, and recovery services for substance use disorder in the
Commonwealth. Using federal grant funding and in collaboration with Health
Resources in Action, DPH has developed a comprehensive website with trainings and
materials to increase opioid awareness and provide resources for Massachusetts
employers to implement policies and practices aimed at prevention and recovery.
This includes the implementation of recovery-supportive
workplace initiatives that focus on injury prevention and
providing employers with the tools to help employees seek and stay in recovery.
Additionally, DPH
recently provided funding for research to UMass Lowell to evaluate and improve
the Opioid Alternative Treatment Pathway program, run by the Massachusetts
Department of Industrial Accidents, which oversees the state’s workers’
compensation system. The program uses a mediation process between insurers and
injured workers who have been prescribed opioids for pain to provide
alternative pain management and support services, including drug treatment,
with the goal of reducing the workers’ dependence on opioid pain medication.
The Healey-Driscoll
Administration fiscal year 2024 budget invests more than $700 million in
substance addiction prevention and treatment programs to address the state’s
overdose crisis, including an expanded 24/7 overdose prevention helpline
available by calling 800-972-0590 and at safe-spot.me.
By establishing the
strong link between work-related injuries and fatal opioid-related overdoses
among Massachusetts workers, this report also underscores the role that
employers, unions, employee assistance programs, and other entities play in
preventing fatal opioid-related overdose. This includes injury prevention, as
well as creating a work environment that fosters communication to help remove
the stigma surrounding substance use and asking for help, providing harm
reduction strategies like naloxone training, and intentionally centering voices
from Hispanic, Black non-Hispanic, and other communities of color in
program-planning and outreach strategies.
Key findings from the
report:
- From 2011 to 2020, there were
117,417 total deaths among working age (16-64 years) Massachusetts
residents.
- Among these, 4,304 – about 4
percent – had at least one workers’ compensation claim with the
Massachusetts Department of Industrial Accidents for a work injury
occurring from 2011 to 2020.
- Of this cohort, 741 died from
opioid-related overdoses; 191 from other substance use/poisonings
(including alcohol); and 3,372 from other causes.
- 87 percent of injured workers
who died from opioid-related overdoses in 2011-2020 were male; 13 percent
female.
- Working age residents who
reported a prior work-related injury were 35 percent more likely to have
died of an opioid-related overdose than all working-age adults (17 percent
vs. 13 percent).
- 84 percent of injured workers who
died from opioid-related overdoses in 2011-2020 were white non-Hispanic;
10 percent were Hispanic; 4 percent were Black non-Hispanic.
- 94 percent of injured workers who
died from opioid-related overdoses in 2011-2020 were born in the United
States.
- Percent of injured workers who
died from opioid-related overdoses in 2011-2020 by occupation:
- 28 percent – construction,
extraction
- 11 percent – transportation,
material moving
- 7 percent – food preparation,
serving related
- 7 percent – production
- 6 percent – building and grounds
cleaning, maintenance
- Leading work-related injuries
among workers who died from opioid-related overdoses in 2011-2020:
strain/sprain (including to the back), crushing or contusion, laceration
or puncture, and fracture.