In theory, employers are in a unique position to confront opioid misuse, through random testing and spotting erratic behavior or absenteeism, said Mr. Chase, the author of “The Opioid Crisis Wake-Up Call.” They could change their health insurance policies to limit opioid prescriptions to five days and waive deductibles for addiction treatment — an option that is often not available to construction firms because they typically do not provide health insurance.
But many employers have been slow to act.
The Nord Family Foundation, a charity in northern Ohio, hosted an event in May in Elyria, near Cleveland, that was designed to teach employers how to identify and treat employees with substance use problems. Dr. Donald S. Sheldon, a trustee at the foundation and a former hospital president, advertised in local newspapers and reserved a room at the local community college that would seat 200.
Just 30 people showed up, he said.
Of the 10 companies whose employees’ suspected opioid overdose deaths were detailed in O.S.H.A. reports since 2014, most did not respond or refused to address specific incidents.
Sam’s Club, a division of Walmart, said in a statement that it provided mental health and substance abuse coverage to employees and offered an employee assistance program. Fiat Chrysler said in an email that it had adopted more stringent opioid prescribing guidelines in its health plan and supported the use of medication-assisted addiction treatment.
Just one employer, Giovanna Painting in Spencerport, N.Y., agreed to an interview. Alan Hart, the company’s president, said he was shocked when one of his employees was discovered dead from a heroin overdose in a port-a-potty on a job site in 2017.
A recovered addict himself, Mr. Hart said he tries to be sympathetic and help workers get into rehab, though he does not provide health insurance.