Substance Abuse in The Texas Oil and Gas Industry

Why the Oilfield Is a Higher-Risk Workplace

Researchers at the National Institute for Occupational Safety and Health (NIOSH) describe the work itself as a set of risk factors: long hours, shiftwork, fatigue, physically demanding work and job insecurity are all linked to substance use among oil and gas extraction workers. Add time away from home, rough weather and the cycle of busy and slow periods, and it is easy to see how stress piles up.

Injuries matter too. NIOSH’s science bulletin on substance use in mining, which also discusses extraction workers, notes that work-related injuries and physical strain can lead to prescription opioid use or self-medication, and that this can progress to misuse. A worker who hurt a back on a rig and was given opioid pain medication is in a different situation from someone who started using on their own. The reason for opioid exposure, current pain, medical history and substance-use pattern are all things a clinician should assess when planning care.

What the Research Does and Does Not Show

Three federal studies come up most often. Here is what each one measured.

Deaths involving substance use. NIOSH built a surveillance database of oil and gas extraction worker deaths and screened it for fatalities involving substance use from 2014 through 2019. It found 26 such deaths. Methamphetamine or amphetamine was the most common substance, identified in 61.5% of them. The study also noted other factors in those deaths, such as not wearing a seatbelt, working in high heat and being on the first day with the company. The catch: these are counts of deaths that already happened. They cannot tell us how many oilfield workers use substances, and they do not show that substance use caused each death.

Everyday health risk factors. A CDC analysis of national survey data from 32 states, 2013 to 2017, found that oil and gas extraction workers and miners had higher rates than nonmanual and other manual workers for most of the health risk factors it studied, with current smoking the exception. Those factors included excessive alcohol use, smokeless tobacco use, inadequate sleep and not always wearing a seatbelt. The study was national and did not break out Texas.

Overdose deaths by occupation. A CDC report on drug overdose deaths by occupation used 2007 to 2012 data from 21 states, including Texas. The “extraction” group, which includes oil and gas, had a proportionate mortality ratio of 1.16 for drug overdose, meaning overdoses made up a somewhat larger share of its deaths than expected. The authors list limits, including that the data say little about where or how a death happened, and that a ratio of this kind cannot show whether the job raised the risk.

The fair summary: the work has real risk factors, and the numbers point the same direction, but none of these studies tells you what share of Texas workers are struggling. Be wary of any article that does.

Substances That Show Up in the Research

Alcohol, stimulants and prescription opioids come up most. Our pages on alcohol, methamphetamine, cocaine and opioids cover each in more depth. Two points apply to the oilfield in particular:

• Stimulants can hide fatigue, which is dangerous around heavy equipment, and they can bring on agitation, paranoia and sleep loss.
• Alcohol and sedatives carry withdrawal risks. Do not stop either suddenly after heavy daily use without medical advice.

Drug Testing, Job Protections and What Is Not Guaranteed

Many workers hold off asking for help because they fear losing the job. The honest answer is that it depends, and nothing here is legal advice. A few points from federal sources:

• The ADA. The Department of Justice’s ADA guidance says the law may protect a qualified person with a disability who is in treatment or recovery and is not currently engaging in illegal drug use, and does not protect current illegal use. Coverage and specific protections depend on the employer and the facts. Employers may adopt reasonable policies, including drug testing. Medication taken as prescribed under a qualified clinician’s supervision is generally different from illegal drug use, but employment and drug-testing rules can be fact-specific.
• The FMLA. The Department of Labor’s fact sheet on the Family and Medical Leave Act says an employee generally needs 12 months with a covered employer, 1,250 hours in the prior 12 months, and an employer with 50 or more employees within 75 miles. Under the federal rule on substance abuse, leave is for treatment by or on referral from a health care provider. It is not for time off because of using, and it does not stop an employer from taking action under a policy that is applied consistently and communicated to employees.
• Safety-sensitive jobs. Some roles have extra testing and return-to-duty rules. Ask HR which apply to yours.

The practical takeaway: before you disclose or sign anything, find out what your employer’s written policy says, whether you have an employee assistance program (EAP), and what each document you sign lets the employer see. Our post on FMLA and rehab goes through the leave process, and our FMLA and addiction treatment article covers the details. If the policy is unclear, an employment attorney can explain it. Do not rely on any treatment center’s promise about your job, including ours.

Finding Treatment That Fits Oilfield Schedules

Level of care should follow assessment, not job title or assumption. A clinician considers withdrawal risk, safety, mental health, home environment and what the person can realistically do. Options range from outpatient care and medication to intensive outpatient and residential treatment. Residential treatment can be the right call for some people, but it is not automatically the best option, and a person with a stable home may do well in a lower level of care.

If you work a rotation, such as weeks on and weeks off, ask programs:

• Can treatment be scheduled during time off, and what happens when you go back to work?
• Is telehealth or evening care available?
• Does the program coordinate with a prescriber near where you live and work?
• What is the plan for the first rotation back on the job?

If Pain Is Part of the Picture

If you started on opioid pain medication after an injury, do not stop abruptly without a plan. Talk to a prescriber about a gradual approach and other ways to manage pain, such as physical therapy and non-opioid medication. Ask whether medication for opioid use disorder fits your situation. Our guide to what the research says about medication treatment explains how those options work.

Questions to Ask Before Return to Duty

1. What does my employer require before I can return, and who decides?
2. What information will the program share with my employer, and what do I have to sign first?
3. Do I need a fitness-for-duty review, follow-up testing or a written plan?
4. How will my care continue once I am back on a rotation?
5. Who can I call if cravings or pain flare up on site?

Managers and HR teams looking for the employer side can start with our guide on what employers can do to help employees.

When to Reach Out for Help

Reach out if substance use is affecting sleep, safety, family or work, or if you are using to get through shifts or manage pain. If you drink heavily every day or take sedatives, get medical advice before stopping. For a possible opioid overdose, such as being hard to wake, slow or stopped breathing, or blue lips, call 911, give naloxone if you have it, and stay with the person until emergency help arrives. If you or someone you know is in emotional crisis, call or text 988. If anyone is in immediate danger or cannot stay safe, call 911 or go to an emergency department.

Talking With a Professional

A first conversation can be confidential and does not commit you to anything. Bring a list of substances and amounts, any injuries and medications, your work schedule, and your questions about privacy and your employer. The admissions team at Discovery Point Retreat can walk you through what an assessment involves and which services are available.

FAQ

Can I lose my job for asking for help?

It depends on your employer, your role and the law. Some federal protections can apply to people in treatment who are not currently using illegally, but they have limits, and employers can enforce consistent policies. Read your employer’s policy and, if needed, talk to an employment attorney.

Will my employer find out I went to treatment?

It depends on what you sign and what your employer requires, such as a referral or a leave certification. Ask any program exactly what it would share and with whom before you consent.

Do all oilfield workers use substances?

No. The studies describe risk factors and specific groups, not every worker.

Do I need residential treatment?

Not necessarily. The right level of care comes from an assessment of your needs, safety and home situation.

What if I only drink?

Alcohol is a substance too, and heavy use can lead to dangerous withdrawal. A clinician can assess severity and options.

Can I get care that works around a rotation schedule?

Some programs may offer scheduling or telehealth options that fit a rotation. Ask each program what it can provide before you commit.

References

1. Ramirez-Cardenas A, Wingate KC, Pompei R, et al. Fatalities Involving Substance Use Among US Oil and Gas Extraction Workers Identified Through an Industry Specific Surveillance System (2014-2019). J Occup Environ Med, 2023. Accessed October 2026. pubmed.ncbi.nlm.nih.gov
2. Yeoman K, Sussell A, Retzer K, Poplin G. Health Risk Factors Among Miners, Oil and Gas Extraction Workers, Other Manual Labor Workers, and Nonmanual Labor Workers, BRFSS 2013-2017, 32 States. Workplace Health Saf, 2020. Accessed October 2026. pubmed.ncbi.nlm.nih.gov
3. Centers for Disease Control and Prevention. Occupational Patterns in Unintentional and Undetermined Drug-Involved and Opioid-Involved Overdose Deaths – United States, 2007-2012. MMWR, 2018. Accessed October 2026. cdc.gov
4. National Institute for Occupational Safety and Health. NIOSH Miner Health Program Addresses Substance Use and Work. NIOSH Science Bulletin, August 2022. Accessed October 2026. cdc.gov
5. U.S. Department of Justice, Civil Rights Division. The ADA and Opioid Use Disorder. Accessed October 2026. ada.gov
6. U.S. Department of Labor, Wage and Hour Division. Fact Sheet #28: The Family and Medical Leave Act. Accessed October 2026. dol.gov
7. 29 CFR 825.119, Leave for treatment of substance abuse. Accessed October 2026. ecfr.gov

Related Reading

• Alcohol Rehab
• FMLA and Rehab
• Workplace Addiction: What Employers Can Do to Help Employees
• Job Stress and Substance Abuse

Resources

• 988 Lifeline. Call or text 988, or chat at 988lifeline.org. Free, confidential support 24/7.
• SAMHSA National Helpline. Call 1-800-662-HELP (4357) or visit the SAMHSA National Helpline page for free, confidential referrals to local treatment.
• 911. For any medical emergency, including a suspected overdose, call 911 immediately.

This article is general education and is not medical advice or legal advice.

If you or someone you work with is struggling, call Discovery Point Retreat at (855) 245-7133 to talk with our admissions team.

Reviewed By: Donnita Smart, LCDC Executive Director - Ennis

Donnita Smart is the Executive Director of Discovery Point Retreat with over a decade of leadership experience in addiction treatment and recovery services. She holds a Bachelor of Science in Social Work from the University of North Texas at Dallas and is a Licensed Chemical Dependency Counselor, with a proven track record in managing multi-site programs, regulatory compliance, and strategic growth. Donnita leads with compassion, accountability, and collaboration, driving programs that support lasting recovery for individuals and families.

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