Substance use and work
With the legalization of recreational cannabis in Canada, questions have been raised about patterns of cannabis use at work, the use of cannabis to treat work-related injuries, and the implications of such uses for work productivity, workplace health and safety and work disability management. IWH research examines these questions, as well as questions about the use and effectiveness of narcotics or opioids to treat pain, including pain associated with work injuries, and patterns of opioid-related harms among workers.
Featured
Research Highlights
Fatal drug overdoses more common among lower-income and unemployed Canadians
A new IWH study looked at how sociodemographic factors measured by the Canadian census were linked with drug overdose deaths.
Published: March 11, 2026

IWH Speaker Series
Using cannabis to manage symptoms of work-related injuries: Experiences of injured workers in Ontario
Published: February 24, 2026
IWH in the media
Opioids linked to longer disability leaves
A Canadian review of five studies have found a link between opioid prescriptions and longer duration of time on disability, writes Sarah Dobson, who interviews Dr. Nancy Carnide and Dr. Andrea Furlan, among others, about implications of this IWH study.
Published: Canadian HR Reporter, June 2018
Journal article
Journal article
A systematic review of strategies to improve appropriate use of opioids and to reduce opioid use disorder and deaths from prescription opioids
Published: Canadian Journal of Pain, June 2018
IWH in the media
High at the helm: Workplaces preparing for cannabis legalization
Virtually nothing is known about why Canadians use cannabis on the job or how common it is for people to consume it at work, says the Institute for Work & Health's Dr. Nancy Carnide in this article on cannabis in the workplace.
Published: The Globe and Mail, April 2018
At Work article
Studies consistent in finding a link between opioids for MSDs and longer work disability
A systematic review on early opioid prescription for MSDs and work disability finds a consistent link with longer work disability. However, review authors urge caution in drawing a conclusion about cause and effect.
Published: February 2018
IWH in the media
Marijuana in the workplace: What is unsafe?
The federal government’s commitment to legalize recreational marijuana by July 1, 2018 raises occupational health and safety concerns for many employers. At the Institute for Work & Health (IWH), we have been reviewing the effects of various drugs that act on the central nervous system — including marijuana — on workplace injuries, deaths and near-misses, write IWH's Dr. Andrea Furlan and Dr. Nancy Carnide. What is striking is how little high-quality evidence there is on the impacts of marijuana in the workplace and how inconsistent the existing data is.
Published: The Conversation, January 2018
IWH in the media
Companies fret about hazy rules around pot use
Once recreational cannabis use becomes legal, taking a “smoke break” at work could suddenly become much more complicated, writes Cassandra Szklarski of the Canadian Press. The Institute for Work & Health's Dr. Andrea Furlan and Dr. Nancy Carnide are among those interviewed.
Published: National Post, December 2017
IWH in the media
Weed at work
The legalization of recreational marijuana in Canada came closer to reality on April 13, when the Justin Trudeau government introduced the Cannabis Act, or Bill C-45. While pot users across the country applaud the move, others have raised concerns about the effect that the proposed legislation would have on workplace safety, writes Jeff Cottrill in an article that quotes the Institute for Work & Health's Dr. Andrea Furlan.
Published: OHS Canada, August 2017
Journal article
Journal article
Early prescription opioid use for musculoskeletal disorders and work outcomes: a systematic review of the literature
Published: Clinical Journal of Pain, July 2017
Project
Project
Central nervous system agents and the risk of workplace injury and death: a systematic review
IWH is leading a systematic review to determine the level and quality of research evidence on the association between workers’ use of agents that act on the central nervous system (e.g. opioids, cannabis) and the risk of workplace injury, reinjury, near misses and death, including outcomes affecting co-workers and others in the immediate workplace.
Status: Completed 2019
Impact case study
WSIB narcotics strategy reducing harm and spending
IWH opioid and chronic pain expert, Dr. Andrea Furlan, helps shape new rules in her role on drug advisory committee.
Published: December 2014