THE BURNED OVER DISTRICT

Once upon a time when you had a job, you waited until after work to shoot up or pop your choice of pills. Nowadays junkies are going to work stoned and occasionally overdosing on the job.

The first time he overdosed on the job, in 2013 at a Virginia construction site, a co-worker who is his cousin stealthily injected a dose of Narcan, an opioid antidote, into Mr. Sullivan’s leg. He woke up and went straight back to work.

The second time, in 2014, his cousin revived him again, and after resting for an hour in his car, Mr. Sullivan was back on the job. His boss told him not to let it happen again. But within a month, Mr. Sullivan had again overdosed on the job site. This time, another worker called 911. After a few hours at the hospital, he went back to work.

As the opioid epidemic continues to rage across the country, with a record 72,000 drug overdose deaths estimated in 2017, the fallout is increasingly manifesting itself at construction sites, factories, warehouses, offices and other workplaces. A stunning 70 percent of employers reported that their businesses had been affected by prescription drug abuse, including absenteeism, positive drug tests, injuries, accidents and overdoses, according to a 2017 survey by the National Safety Council, a research and advocacy organization.

At least 217 workers died from an unintentional drug or alcohol overdose while at work in 2016, up 32 percent from 2015, according to the Bureau of Labor Statistics. Workplace overdose deaths have been increasing by 25 percent or more a year since 2010. Those numbers don’t include the many more overdoses that don’t end in death, like Mr. Sullivan’s, or accidents caused primarily or partly by drug impairment.

Incident reports from the Occupational Safety and Health Administration paint a grim national picture of workplace overdose deaths: a mechanic at a Fiat Chrysler Automobiles plant in Michigan, a construction worker on a barge in Rhode Island, a crawfish fisherman in Louisiana and a Sam’s Club worker who died while stocking shelves in a Texas warehouse.

But despite the growing problem, many employers have turned a blind eye to addiction within their work force, ill-equipped or unwilling to confront a complicated issue they do not know how to address, according to researchers and business executives.

The National Safety Council survey, which was based on interviews with 501 managers at businesses with 50 or more employees, found that fewer than one in five companies felt extremely well-prepared to combat the opioid crisis. Just 13 percent were very confident they could identify risky use. And a little more than half said they screened all employees for drugs, but 40 percent of those had failed to screen for synthetic opioids like oxycodone and fentanyl.

“Employers have been asleep at the wheel,” said Dave Chase, co-founder of Health Rosetta, a company that certifies employer health benefits, and author of “The Opioid Crisis Wake-Up Call.” Some companies are “key, unwitting enablers,” he added.

It is not that businesses are unaware of the toll the crisis is taking. Large employers spent $2.6 billion on treating opioid abuse and overdoses in 2016, up from $300 million 12 years earlier, according to the Peterson-Kaiser Health System Tracker. Those numbers do not include the cost of lost productivity. Workers who misuse pain medication miss an average of 29 days a year, compared with 10 and a half days for other employees.

Yet, many managers are unwilling to acknowledge drug use at their businesses.

“If you ask them if they believe they have an opioid problem within their population, a very high percentage of them would say, ‘No, we don’t,’” said Pat Sullivan, executive vice president of employee benefits at Hylant, a large insurance broker in Indiana that manages benefit plans for more than 19,000 businesses. “And yet we have access to prescription reports that are absolutely telling me there’s abuse happening” among their workers.

In days past the work site first aid kit had bandages and antiseptics and maybe aspirin. Now it better have Narcan unless the boss can easily replace you. With heroin cheap and easy and opioid manufacturers cranking out as many pills and patches as possible, any workplace can now be where you go to die.