Occupational Differences in Opioid-Related Overdose Deaths: A Retrospective Descriptive Analysis

In California, opioid overdose deaths increased from 2018 to 2023, yet limited data exist on disparities among workers. This study characterized opioid-related overdose deaths in California by usual occupation to inform workplace interventions.

We analyzed usual occupation information on death certificates for California working age (16-65) decedents who died of an opioid-related overdose from 2019 to 2023. We identified deaths with a final cause of death ICD-10 code indicating drug-poisoning, involving at least one opioid. We estimated age-adjusted mortality rates by occupation.

There were 22,166 opioid overdose deaths among working age decedents in California from 2019-2023. The overall age-adjusted mortality rate was 24.9 (CI: 24.5-25.2) deaths per 100,000 workers. Construction and Extraction occupations accounted for nearly one-fifth of deaths (19.5%) and had the highest rate (100.9, CI: 97.9-104.1). Deaths by occupation varied by sex: men were concentrated in Construction and Extraction, while women were in Sales, Healthcare Support, and Office and Administrative occupations.

Construction and Extraction occupations had the highest opioid overdose death rate. Workplace interventions are needed, including overdose prevention education, recovery resources for employees with opioid use disorder, access to naloxone, and addressing hazards that lead to injuries for which opioids may be prescribed.