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In January 2024, NSC surveyed more than 500 employers and 800 employees across all industries on their perceptions of opioid use, overdose and naloxone. The main theme emerging from the results was disconnection — between awareness and adoption, community and workplace, use and safety, and support and stigma. It is within these gaps we find opportunities to create meaningful impact and positive change. View the full survey findings and the survey infographic.
Awareness and Adoption: 85% of employers and 78% of employees are aware of naloxone. While we view this as a positive step in addressing the opioid overdose crisis in workplaces, the survey responses highlight possible gaps between knowledge, awareness and availability.
While 30% of employees said their workplace had naloxone on site, nearly half (46%) of employees in workplaces without naloxone do not expect their workplace will begin stocking it. And while most respondents (89%) said their workplace had first aid kits, just 43% of employers and 30% of employees said their workplaces had an opioid overdose response kit.
While half of employer respondents indicated having naloxone at their work site, this did not mean naloxone was universally available. Of employers with naloxone, 28% said they stock naloxone at all work sites, 15% said they stock naloxone at some work sites and were looking to increase availability, and 8% said they stock naloxone at some work sites and were not looking to increase availability.
Community and Workplace: Employers (79%) and employees (74%) both indicated opioid use is a problem in workplaces across the country. Additionally, 75% of employers and 67% of employees said opioid use was a problem in their community. Yet when it came to workplace specifics, just 64% of employeees indicated they were concerned about opioid use impacting their workplace and only 55% were concerned about an overdose impacting their workplace. Meanwhile, 78% of employers were concerned about opioid use impacting their workplace and 70% were concerned about an overdose impacting their workplace.
Use and Safety: As for opioid use impacting the safety of their workplace, 62% of employers and 47% of employees agree that it does. When asked if opioid use causes more near misses and injuries, 50% of employers and 39% of employees said yes. Future research might be useful to better understand workplace perceptions on what problems opioid use is causing in the workplace.
Support and Stigma: While we’d like to see this answer at 100%, a positive 77% of employers and 80% of employees agree that substance use (as defined in the survey) is a chronic medical condition warranting treatment and support. Despite this, when it came to more nuanced statements about how substance use might play out in the workplace, 70% of employers and 60% of employees agreed substance use was a justifiable reason to fire an employee, and 56% of employers and employees agreed substance use was a threat to their company’s reputation. Even more concerning as we work to combat stigma, 51% of employers and 44% of employees said substance use was a signal an employee cannot be trusted, and 50% of employers and 41% of employees said substance use was a personal moral or ethical failure.
Leaning into this potential disconnect, most employers (86%) and employees (80%) think workplaces should support employees struggling with substance use, and 79% of employees said they would be more likely to work for an employer that provides resources for substance use. However, when it came to awareness of how workplaces could support workers, just 42% of employers and 28% of employees knew about recovery-supportive, recovery-ready or recovery-friendly practices.
We know the construction industry has been hit hard by the opioid and overdose epidemics — with the highest rates of overdose of any industry. While most questions had similar answers across industry, we found statistically significant differences with respondents in the construction industry:
They were more likely to indicate opioid use is:
● A problem in their workplace
● Causing more near misses or injuries
● Decreasing the morale of employees
● Harming the safety of their workplace
● Lowering the productivity at their workplace
● A problem in their community
● A threat to their employer’s reputation
They were more likely to be aware of:
● Near misses related to opioid use
● Injuries related to opioid use
● The negative impact of opioid use on morale
● Selling opioids at work
They were more likely to:
● Have naloxone stocked at work
● Know how to get naloxone in their community
● Have anonymous access to naloxone at work
● Be familiar with policies relating to naloxone
Ninety percent of construction industry respondents would be more likely to work for an employer that provides resources to employees regarding substance use.
Employers that had experienced an overdose in their workplace were more likely to:
● Be concerned that opioids were impacting their workplace
● Be concerned about an overdose in their workplace
● Stock naloxone
Employers that had adopted recovery supportive policies were more likely to:
● Be concerned about opioid use impacting the workplace
● Be concerned about an overdose in the workplace and other wellbeing-related risks (including cannabis, fatigue and other substance use)
● Be concerned that substance use was harming the safety of their workplace
Employees with personal experience related to substance use disorder were more likely to agree that substance use is:
● A problem in workplaces across the country, in their community and in their workplace
● Harming the safety of their workplace
● Lowering productivity at their workplace
● Decreasing morale at their workplace
● Causing more near misses or injuries
While some statistically significant differences between different respondent groups emerged, the responses were still relatively small percentages. This could potentially be another example of the disconnection we saw across the survey.
Respondents from the construction industry were more likely to have naloxone stocked at work compared to respondents from other industries. While statistically significant, these percentages were less than half: 40% (construction) compared to 28% (others). This demonstrates that even in a hard-hit industry like construction, naloxone saturation may not be at acceptable or needed levels.
Of employers that had experienced an overdose in their workplace, 67% indicated concern about overdose. Of employers that had not experienced an overdose, 39% indicated they were concerned about overdose. So, even where overdose has occurred, not all respondents indicated concern about overdose.
As we increase awareness and knowledge of opioids, naloxone and the impact on workplaces, opportunities increase to help workplaces implement opioid overdose response programs. NSC offers an implementation guide to help workplaces begin stocking naloxone, expand naloxone availability and update their policies. The NSC Connect2Prevent program is for workplaces and workers interested in learning how to talk with family members about opioids. The new NSC Naloxone for Suspected Opioid Overdose eLearning also is available for free.
A potential barrier to bridging the gap between acknowledging substance use disorder as a chronic disease and supporting workers struggling with substance use is to address stigma. Workplaces can invest in employee training, adopt anti-stigma language, invest in comprehensive benefits, and create a stigma-free and psychologically safe workplace. Find out more.
As government, advocacy and workplace leaders strive to address substance use in the workplace, recovery-supportive workplaces offer some promise. NSC includes recovery-informed recommendations throughout the Workplace Wellbeing Hub.
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