It is well known that fishing workers, along with those working in construction, have significantly higher rates of opioid-involved overdose deaths than almost any other industry. Around two in five of the 60,000 fishing workers in the United States have experienced either an opioid-involved overdose or a substance-related accident or injury while on the job.
Being a fisherperson is tough, more than many of us can really imagine. It’s physically grueling and dangerous, with long, intense hours and the feelings of loneliness that can come with being away at sea. What many of us do not often stop to think about is how fishing workers, who do not receive sick time or paid vacation, face relentless issues maintaining health insurance coverage due to their fluctuating incomes.
“Fishing people simply do not have health equity the way things are right now,” said Deb Kelsey, a community health navigator for Fishing Partnership Support Services in New Bedford, Massachusetts. “If someone is in pain or sick, the vessel does not turn around once they are out at sea—that is not an option. They work through the pain.”
This combination of extraordinarily challenging work conditions and health-care vulnerability creates a need for many people to find their own ways to cope. Drugs are one obvious option. Respiratory depressants such as prescribed and street opioids, benzodiazepines and alcohol are all in the mix. They could be taken to calm the nerves, ease pain or endure bad weather and rough seas. Stimulants are used too, as a way to fight that inevitable fatigue.
“Sometimes it’s lonely and cold, being down in the fish-hole just tossing fish for hours and hours,” Mike, a young fisherman, told me. “Gives you a lot of time to think, and not always of the good stuff, you know?”
Combining certain substances significantly increases risks, especially given the prevalence of fentanyl and its analogs in our current drug supply—pointing to the need for more education and resources. But polysubstance use, in commercial fishing and many other industries, serves its purpose to support people in getting the work done.
While drugs’ benefits to job performance are often overlooked, such publicity as is afforded to drug use in commercial fishing focuses solely on the negative impacts, such as at-sea overdose or overamping. Despite the urgency of reducing harms, this focus can result in the further stigmatization of fishing people who use drugs and their families.
Members of tight-knit fishing communities have often described to me how finding acceptance for the substance use that’s part of their daily lives feels like a grief-weighted struggle against decades of entrenched cultural stigma and internal shame.
In many ways, fishing people—with their traditions of solidarity, practicality and mutual aid—are natural harm reductionists already.
Harm reduction has always held space for people who have been able to navigate their work and lives while using drugs. It acknowledges that drug use is a fact, not something to fight against. It also leaves room to acknowledge the often complex trauma that can build from intergenerational secrecy around drug use, from fear of punitive consequences and from the realities of a hazardous livelihood.
If fishing workers could have safe spaces to talk about their drug use, injuries and pain, if they could feel less at risk of losing their jobs in risk-reduction conversations with their captains and employers, the sea would be a much safer place.
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