Occupational Differences in Opioid-Related Overdose Deaths: A Retrospective Descriptive Analysis
Kathryn Gibb1, Natalie Demeter2, Jennifer Flattery1
1Occupational Health Branch, California Department of Public Health, Richmond, California, USA.
Substance Use & Misuse
|August 14, 2026
Summary
Opioid overdose deaths are rising among California workers. Construction and Extraction jobs show the highest mortality rates, highlighting the need for targeted workplace interventions and overdose prevention education.
Area of Science:
- Occupational Health
- Public Health
- Epidemiology
Background:
- Opioid overdose deaths in California have increased between 2018 and 2023.
- Limited data exist on occupational disparities in these deaths.
- This study aimed to characterize opioid-related overdose fatalities by usual occupation.
Purpose of the Study:
- To analyze opioid overdose deaths among working-age Californians (16-65) from 2019 to 2023.
- To identify occupations with the highest burden of opioid overdose deaths.
- To inform the development of targeted workplace interventions.
Main Methods:
- Utilized death certificate data for California decedents aged 16-65 from 2019-2023.
- Identified opioid-related overdose deaths using ICD-10 codes for drug poisoning involving opioids.
- Calculated age-adjusted mortality rates stratified by usual occupation.
Main Results:
- A total of 22,166 opioid overdose deaths occurred among working-age Californians.
- The overall age-adjusted mortality rate was 24.9 deaths per 100,000 workers.
- Construction and Extraction occupations had the highest mortality rate (100.9 per 100,000) and represented 19.5% of all deaths. Significant sex-based differences in occupational distribution were observed.
Conclusions:
- Construction and Extraction occupations face the highest risk of opioid overdose deaths.
- Workplace interventions are crucial, including overdose prevention, naloxone access, and addressing occupational hazards.
- Support for employees with opioid use disorder is essential.
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