In recent years, these highly addictive drugs have become deadlier, as a powerful synthetic opioid fentanyl has been increasingly mixed into heroin. Fentanyl has also been found in cocaine. The DEA considers fentanyl to be approximately 50 times more potent than heroin.

Andrew Kolodny is the co-director of Opioid Policy Research at the Heller School for Social Policy and Management and the executive director of Physicians for Responsible Opioid Prescribing. He has treated restaurant workers in the past.

The accommodation and foodservice industries have the highest rates of illicit drug use.

Joshua Miller is a restaurant owner and Rhode Island state senator who advocates for helping employees suffering from addiction and hiring people in recovery. But it’s not just employees impacted by this crisis, according to Miller.

In a recent study published in the International Journal of Drug Policy (which took place in New York City and included coffee shops, sit-down and fast-food restaurants, as well as non-food establishments like laundromats), seven of the 86 managers surveyed reported encountering unresponsive individuals who required emergency assistance. But 90 percent of managers had received no overdose recognition or naloxone training.

White Castle was one of the only national chains Nation’s Restaurant News reached out to that was willing to speak on the topic of opioid abuse. The burger chain is based in Ohio, one of the hardest-hit states in the opioid crisis.

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