Naloxone cabinets help union sheet metal workers save lives

Doses of opioid antagonist sent to union halls, training centers across the United States and Canada

Jerry G. Hovarter, business manager and financial secretary/ treasurer for Oklahoma’s Local 124, received a phone call in March 2023 that changed everything.

“The call came on a Sunday morning regarding one of our first-year apprentices,” he recalls. “He had passed away from a drug overdose the day before.”

In September that same year, SMOHIT reached out to Hovarter about another first-year apprentice, this apprentice reaching out through the hotline for help. Between SMOHIT and Local 124, he was able to access treatment, but that was just the beginning of his story.

“Unfortunately, he could not overcome his addictions and passed away on July 3, 2024, from an overdose,” Hovarter says. “When SMOHIT offered naloxone cabinets for the apprenticeship training center and for the union hall, I was all-in to install a cabinet at both locations. I hope we never have to use it, but being prepared and having it available could save a life.”

It is because of stories like this that SMOHIT—the health and safety arm of the unionized sheet metal, air conditioning and welding industry—has launched an initiative to provide union halls and training centers with a free Naloxone (Narcan) cabinet containing four boxes, or eight doses, of the substance, which is a potent synthetic antagonist for opioid drugs, including morphine and fentanyl.

Boxes contain detailed, illustrated instructions on how to administer the drug in case of suspected overdose, which is as easy as spraying the dose inside the patient’s nose. The metal cabinets are not alarmed and are meant to be hung in highly visible areas, said Jeff Bradley, SMOHIT program administrator. “We wanted to make it accessible to as many people as possible,” he said. “If they run out, they can always order more from us at no direct cost.”

Hildreth, manager construction division for Corporation in Kansas, says having the cabinets on site can make a life and death difference. “Beyond that, by making naloxone readily available we normalize conversations about substance use and the resources that SMOHIT provides to our members,” he says, encouraging SMACNA contractors to support the initiative by following suit.

“We can use the cabinets and talk more openly with our crews about why we’re making naloxone available,” he says. “Also, we can treat overdose response like we do first aid, CPR, and AED training and make it a part of our safety culture. Visible support from company leadership makes it clear that this is about supporting all our people.”

The cabinets’ doses are available for whoever needs them, whether the suspected overdose occurs inside a union building or elsewhere.

The cabinets’ doses are available for whoever needs them, whether the suspected overdose occurs inside a union building or elsewhere. Members can take a box if they’re concerned about a family member or take one to keep at the job site.

“The cabinets and doses were purchased to help members save lives, inside and outside of union buildings,” Bradley added. “An overdose can happen to anyone, anywhere, and it’s good to be prepared no matter the circumstances.”

Bradley encourages SMACNA contractor and union leadership to address communication about the kits with a general education approach to help reduce the stigma around substance use. “The benefits of carrying naloxone help union members, their friends, and their family,” he says. “I make naloxone available to all of my kids, who are in their 20s, and they take it without question. The younger generations are familiar with it and are willing to help if the need arises without judgment.”

Construction workers build their careers in dangerous situations. Even with every safety measure in place, injuries happen, and when they do, 55% of injured construction workers receive a prescription opioid to manage the pain. Of those injured workers, 29% receive two or more opioid prescriptions, according to a study from Workers Compensation Research Institute.

Although the rate of overdose deaths in the United States decreased almost 27% from 2023 to 2024, union construction workers are 10 times more likely to develop an opioid use disorder if given a long-term prescription, according to the Centers for Disease Control and Prevention (CDC).

“The primary reason we’ve experienced a significant drop in opioid overdoses has been the presence of naloxone, so it’s vital we make sure it is visible and available throughout our industry,” says Chris Carlough, SMART director of wellness and mental health support.

But it’s not only injured workers who should have naloxone on hand. Opioid overdose can happen to anyone who is taking the medication or who purchases any kind of medication from anywhere other than a licensed pharmacy, including social media and the internet. “Workers who share medications or teenagers who buy anxiety medications off of social media ads are all at risk because counterfeit opioids look just like the real thing,” Carlough says.

In fact, if an opioid drug is in the medicine cabinet at a worker’s home, they should have a kit at the ready. Senior citizens are often prescribed naloxone in addition to any opioid medication in case of accidental overdose. With children, even teens, in the home, naloxone is a good thing to have on hand in the case the unthinkable happens.

At the end of May, 119 orders have been placed, with more requested over the summer. Approximately 72 sheet metal union halls and 154 training centers will have naloxone cabinets in their buildings by next year, Bradley expects.

Labor and management can work together to shift the workplace culture around health and safety relating to injury and opioid use. “Workplace safety education and enforcement are paramount, along with ergonomics,” Bradley says. “Preventing injuries that necessitate prescription medication serves as an effective deterrent to opioid use. Promote alternatives like physical therapy, mindfulness, and non-opioid pain relief.”

Each year, on the first day of class, Hovarter addresses students with information about SMOHIT and the union’s employee assistant program (EAP). In that conversation, he includes contact information for ways to seek help with drug or family issues they may be experiencing, and now he draws attention to the naloxone cabinet.

He adds that contractors can help support the initiative by sharing with employees the SMOHIT and EAP contact information in person and on shop and jobsite billboards.

“Our contractors do support our determination to get our members the best quality care for drug or alcohol addiction,” he says. “They usually call me to reach out to any members in need.”

Lon Fett, secretary/treasurer at Harrison-Orr Air Conditioning, LLC in Oklahoma, sees the benefits of having the cabinets in place and sees the initiative as something unions and contractors should be adopting together.

“Hopefully, that cabinet never has to be used, but we’d rather have it and not need it, than need it and not have it,” he says. “Secondly, having the cabinets in place should, hopefully, help bring awareness to the issue of addiction.”

He acknowledges that, much like mental health awareness in the past, addiction is something not typically discussed openly.

“We, as an industry, must change that,” he says. “Having the cabinets in place can help drive the conversations needed to bring awareness to those in the labor force.”

He encourages contractors to consider having a Naloxone cabinet in their offices and shops, noting contractors can’t expect training centers and union halls to be 100% responsible for bringing awareness to issues of addiction.

“We’ve got to get behind it,” he says. “Contractors can include awareness training and how to identify signs of addiction in our safety programs and jobsite “toolbox talks,” as well as encourage the use of available resources—like the SMOHIT hotline and EAP—that help deal with these types of issues.

“Hopefully, if the information is shared enough, workers will be more likely to use it, if needed.”

To request a naloxone kit for your training center, union hall, or office, reach out to SMOHIT at 703-739-7130. 

Jessica Kirby is editor-publisher for Point One Media, a small but sturdy family-owned trade magazine creator representing some of North America’s best construction associations. She can usually be found among piles of paper in her home office or exploring British Columbia’s incredible wilderness.

If you or anyone you know is suffering from addiction or struggles with substance misuse, please reach out to the SMOHIT hotline at 1-877-884-6227.