To truly understand the opioid crisis and the need to protect construction workers before their very first use of opioids, the first part of this article presents a detailed background on the origins of the epidemic and risks of Opioid Use Disorder (OUD) in the U.S. The second part dives into eight strategies to help prevent first dose exposure through alternative pain management and prevention, improved communication with health care providers, and how to safely store and dispose of medication.