Be Well Texas is a statewide substance use services program run by UT Health San Antonio. Leaders from the program said substances these days are much more concentrated and more addictive than they used to be, and intervening as young as possible is crucial for youth brain development. Now their program is going virtual-- expanding their reach beyond San Antonio.
Watch the full story on ksat.com
The industry is taking steps to address opioid addiction, provide Narcan training and expand mental health support on jobsites to combat worker struggles.
The construction industry is built on the strength of materials, structures, teams and individuals. Yet even the most resilient workforces are vulnerable to the challenges of today’s world. In recent years, the rise of drug overdose deaths across the United States has reached crisis levels, with Bexar County, Texas, home to San Antonio, seeing some of its highest numbers in history. While often viewed through a public health lens, this epidemic deeply affects industries like construction, where the physical demands of the job can intersect with mental health and substance use challenges.
Construction workers perform physically demanding labor, often under high-pressure conditions. Long hours, physical strain and the risk of injury can lead to chronic pain, which are frequently treated with prescription opioids. What begins as legitimate pain management can quickly evolve into dependency, especially without the right support structures in place. Nationally, construction workers are estimated to be seven times more likely to die from an opioid overdose than the average worker, underscoring the need for industry-specific solutions.
Under Skanska’s Care for Life framework, safety includes both physical and psychological well-being. In response to the growing threat of opioid misuse, Skanska has taken proactive steps to ensure its teams are prepared, informed and supported in the face of this challenge.
To address the growing need for overdose prevention and response training, Skanska has partnered with Be Well, Texas, a program committed to increasing access to substance use education, prevention, and treatment. The Texas Health and Human Services Commission supports this program through federal funding from the Substance Abuse and Mental Health Services Administration, as well as other state and federal funds. The collaboration led to on-site Narcan training sessions for workers, focusing on how to recognize signs of an opioid overdose and how to administer Naloxone (Narcan), a life-saving medication that can reverse opioid effects in minutes.
Each participant in the training received a Narcan kit to carry with them. While substance use is not tolerated on jobsites, the reality is that workers may encounter drug-related emergencies near or around project locations. Equipping them with the knowledge and tools to respond appropriately.
Just as overdose response training equips teams to act in emergencies, addressing mental health may help to proactively prevent crises before they occur.
The opioid crisis cannot be separated from the broader context of mental health in construction. The industry has long faced cultural and structural challenges related to mental well-being. The “tough-it-out” mindset, combined with job-related stress, long hours and sometimes unpredictable income, creates an environment where mental health struggles often go unrecognized and unaddressed.
Skanska has taken steps to break down these barriers through the Green Sticker Program, which trains and certifies employees as “Mental Health First Aiders”. These individuals are equipped to identify early signs of mental health issues or emotional distress and to connect their peers with appropriate resources. The program is integrated into the overall safety approach and reinforces the message that mental health is just as important as physical safety on the jobsite.
With suicide rates in construction among the highest of any industry, this level of intervention is essential. September, which marks Suicide Prevention Awareness Month, is a particularly relevant time to spotlight these efforts. But awareness and action cannot be limited to one month a year. For initiatives like these to be effective, they must be sustained and supported year-round.
This means embedding mental health support into daily operations, not just as a safety protocol. It requires leaders at every level to support open dialogue, reduce stigma, and ensure that resources are accessible and visible. When mental health becomes part of everyday conversation, a culture is created where seeking help is seen as a strength, not a weakness.
Traditional safety programs in construction have mainly focused on hazard avoidance, fall prevention and equipment protocols. While those remain critical, today’s environment calls for a more holistic approach that incorporates mental health literacy, overdose prevention, emotional resilience and physical health.
Incorporating elements such as toolbox talks, safety briefings and daily jobsite meetings now integrate themes that go beyond physical hazards. Topics include stress management, substance misuse awareness, crisis response planning, and access to confidential counseling and recovery support services.
In addition to internal programs, partnerships with external experts like Be Well, Texas, and even the American Heart Association, which has programs for walking and blood pressure challenges, can be vital for any group. These organizations bring clinical knowledge and a non-judgmental perspective that helps normalize conversations around substance use and mental and physical health. Their involvement ensures initiatives are rooted in best practices and community-specific expertise.
The goal is not to turn every construction worker into a mental health expert or emergency responder. Instead, the goal is to empower the workforce with the awareness, tools and confidence to act should a difficult situation arise. This can mean administering Narcan, encouraging a peer to seek help or simply knowing when and how to escalate a concern.
Workers who feel supported are more likely to seek help and engage in safer behaviors on and off the jobsite. Working toward a cultural shift in construction that is more open is one of the most powerful safety tools a company can deploy. It also contributes to overall teamwork.
The challenges facing the construction industry today are complex. Addressing them requires leadership willing to challenge outdated norms and confront these issues head-on. By investing in education, strategic partnerships and a culture of care, we’re not just protecting our workforce; we’re redefining what safety means in our industry.
Committing to the long-term health and well-being of every team member isn’t just good for productivity, it’s the right thing to do. Training, wellness services and mental health support are essential components of a modern safety strategy. When we prioritize the whole person, we build stronger teams, safer jobsites and a more resilient future for construction.
The medication can counteract a fentanyl or opioid overdose, the organization says
Watch full interview here
SAN ANTONIO – Naloxone Texas is working to ensure the life-saving medication is easily accessible and available at every college campus in the state.
“In Texas, there’s legislation for K through 12 schools, and there’s legislation for other workforces, but there’s not really a systematic way of getting into our colleges and universities,” said Dr. Tara Karns-Wright. “It’s so important for college students because we know that fentanyl is actually the leading cause of death for individuals ages 18 to 45. And so that encapsulates that age group”.
Karns-Wright is the director of Naloxone Texas, a program of the Be Well Institute on Substance Use and Related Disorders at the University of Texas at San Antonio (UTSA) and its patient-care enterprise, UT Health San Antonio.
Karnes-Wright is also an assistant professor in the Department of Psychiatry and Behavioral Sciences at the UT San Antonio Health Science Center.
“If there’s a college party, for example, and students may think they’re taking a Xanax or an Adderall, there actually could be fentanyl in that pill, unfortunately,“ Karns-Wright said. ”And if they don’t know that, they could overdose from that ingestion of that pill."
Some UTSA students said everyone they know has been affected by fentanyl, either through an accidental overdose of someone they know or a loved one.
“It was really, really tragic. It took time for people to get back into their daily lives, and it really affected a lot of people personally," said Joaquin Ventimilla.
After a demonstration of how naloxone works, many students were surprised to learn it wasn’t already on campuses across Texas.
“I think it’s not even like college campuses everywhere, but yeah, I think this is the best place to have them for sure,” said Rida Hussiaw and Yoalli Echeverria.
Naloxone Texas is working with as many colleges and universities as possible. Organizations interested in receiving free medication or training should contact them through their website.
Free naloxone and training offered to Texas colleges, community colleges and trade schools this fall
Naloxone Texas, a program of the Be Well Institute on Substance Use and Related Disorders at the University of Texas at San Antonio Health Science Center, is launching a new initiative this fall aimed at colleges and universities across Texas to distribute free naloxone and provide overdose response training to students, faculty and staff.
The effort targets public and private universities, community colleges and trade schools in response to the growing opioid crisis affecting young adults in the state. Naloxone, known commercially as Narcan, is a medication that can rapidly reverse an opioid overdose and save lives when administered quickly. Much like defibrillators or epinephrine auto-injectors (EpiPens), naloxone is a simple but powerful tool that can help bystanders respond in emergency situations before medical professionals arrive.
“Naloxone is more than a medication. It’s a tool that empowers students, friends and communities to save lives,” said Tara E. Karns-Wright, PhD, MS, director of Naloxone Texas and assistant professor in the Department of Psychiatry and Behavioral Sciences at the Health Science Center. “At Naloxone Texas, we believe every college campus should be equipped with the knowledge and resources to respond to an opioid overdose. Thanks to the generous support of our funders at the Texas Health and Human Services Commission and the Texas Legislature, we’re making this life-saving medication more accessible and helping everyone become first responders in moments that matter most.”
Naloxone Texas will also participate in several back-to-school events at community colleges across the state this fall, including campuses in Austin, Houston and San Antonio. At these events, students and staff will have the opportunity to sign up for free naloxone kits, learn how to use them and ask questions about overdose prevention and treatment resources.
Event dates, locations, fact sheets, logos, b-roll and Spanish collateral can be found at this Dropbox link.
College administrators, student health services and campus organizations are encouraged to request free naloxone kits and schedule training sessions by visiting www.naloxonetexas.com. Tailored training programs and bulk naloxone orders are available.
Through funding from the Texas Health and Human Services Commission and support from the Texas Legislature, Naloxone Texas offers access to overdose reversal medication and pathways to next steps. Services include:
DENTON, Texas — According to Texas Health and Human Services (HHS), the state is experiencing a drug poisoning epidemic. Included in that epidemic is a rising number of opioid overdoses. One such incident inspired a novel solution.
Chad Wither, general manager of Rubber Gloves Rehearsal Studios, a Denton nightclub, recalls a scary situation with an 18-year-old who was overdosing on opiates.
“I had a Narcan right there,” Wither said. “Pulled it, gave it to them, and they went over and administered it, and that person was, looked like, essentially brought back to life.”
The experience inspired him to put a free naloxone machine outside the club. Also known by its brand name Narcan, the nasal spray can reverse the effects of an opioid overdose.
Though it looks like a typical vending machine, this one has the potential to save lives. Just as with a standard vending machine, Narcan is dispensed by punching in a code and collecting the spray from the tray. In this case, no payment is required.
It’s the first Narcan machine issued through the statewide initiative Be Well Texas and its public health program Naloxone Texas. And it already seems to be working.
“We’ve already had to restock it twice. We’ve only had it a week so far,” Wither said.
Dr. Tara Karns-Wright directs the program throughthe University of Texas Health Science Center at San Antonio.
“We are really trying to address the opioid crisis by providing tools on the ground that will help to address things like overdoses,” Karns-Wright said.
And — though the Centers for Disease Control and Prevention data shows opioid overdose deaths were down 27% nationwide from over 83,000 to roughly 55,000 in 2024 — a state health services program called Texas Overdose Data to Action reports drug poisoning deaths including opioid overdoses have increased over 75% in the last five years in Texas.
Karns-Wright says free Narcan machines provided through state funding are part of the solution. They plan to place 112 machines around the state.
“The other really potential solutions are prevention and treatment,” she said. “And so one of the things we try to do at Naloxone Texas is link to treatment if we can.”
DENTON, Texas - A vending machine in Denton aims to prevent overdose deaths. It's filled with the life-saving drug naloxone, a medication designed to reverse opioid overdoses.
The most valuable vending machines around can save a life. Naloxone Texas is an initiative of the group, ‘Be Well Texas’ at UT Health Science Center in San Antonio.
On Tuesday, a Denton nightclub, The Rubber Gloves Rehearsal Studio, became the group's first site for this 24-hour easy-to-use, free-of-charge vending machine. A vending machine that dispenses Narcan, the brand name for the drug Naloxone, is now available without a prescription.
What they're saying: "Others do exist in the state, but this is our first vending machine we’re deploying, so we’ll have a total of 112 in Texas that we’re deploying all over," said Tara Karns-Wright with Noloxone Texas.
A presentation with a DEA special agent demonstrates how to administer the nasal pump dose to save anyone who has just overdosed. Something that happened at this club sparked the management’s decision to be a site for a naloxone machine.
"A young person, 18-years old, experienced an overdose, just took a pill. They didn’t know what it was. A patron found them and, luckily, we had Narcan behind the counter, and actually, one of the patrons administered it, and we were able to save that young person’s life," said Chad Withers of Rubber Gloves Rehearsal Studio.
"Venues like this are where people come to socialize and hang out, and drugs may be prevalent. We just want to make sure everyone knows there are things that can be done to help," said Karns-Wright.
What's next: Federal and state grant money allows for the purchase of the Narcan they fill those machines with.
A UT Health San Antonio initiative was selected to lead a major expansion of opioid use disorder and recovery support services across Texas.
Be Well Texas, an initiative of the Be Well Institute on Substance Use and Related Disorders, was awarded $256 million over four years by the Texas Health and Human Services Commission to administer medications like Naloxone for opioid use disorder treatment services and to continue offering recovery support services.
Dr. Jennifer Sharpe Potter, founding director of the Be Well Institute, said the partnership between the university and the commission is a major commitment to support solutions to the opioid crisis.
“The partnership, in and of itself, is noteworthy, because this is an opportunity for us to support the state in delivering these services,” Potter said. “The expansion is about making sure people have access. We continue to see opportunities to improve the amount of funds that go to these services statewide.”
Potter said the funding will be used to begin youth recovery services and expand outpatient opioid use disorder treatment. She said the initiative will also see an expansion of access to methadone, which is provided through opioid treatment programs.
“We are honored to be able to manage, on behalf of Texas Health and Human Services, the contracted treatment programs for methadone throughout the State of Texas,” Potter said. “We’re particularly proud that the state has seen the work that we've done and trusts us with this important delivery model.”
TPR’s journalism is free to read, but not free to produce. If you believe in independent, local journalism, help us keep it going.
Potter said youth support services are critical because they limit how long opioid use disorder is a burden on an individual and put them on a path to recovery.
“We’ve seen in Texas an increase in the number of individuals under the age of 18 who've been adversely impacted by opioids,” Potter said. “While not all of those individuals may have had an opioid use disorder, we want to be able to provide them with support related to their opioid use.”
Be Well Texas partners with local practices to provide treatment to people with opioid use disorder across the state. Potter said this funding will allow the initiative to continue working with local partners and also leverage telehealth services to ensure rural and urban communities alike have increased access to treatment.
“The most important thing is that you lean into local, community based, semi-governmental and private practice groups who can be part of the solution,” Potter said. “It’s not top-down dictates — it’s working with the local community to find a solution that makes sense.”
Potter said state funding is the backbone of the services the initiative offers, especially in Texas where some people do not have access to health insurance.
“We would not be able to do this work without the state support,” Potter said. “There would be a sizable number of individuals who would go without treatment, and that would increase the number of deaths in Texas related to addiction.”
Potter said she hopes the work the initiative does creates less stigma associated with asking for help with substance abuse in Texas. The Be Well Initiative is also a research entity that is working to support development of new treatment options.
“We hope, at the institute, to create access to even newer and better treatments, just like you would for any other disease,” Potter said. “We’re not just delivering service with treatments. We're hoping to invent, discover, and be part of providing other treatments in the future.”
SAN ANTONIO, July 16, 2025 – The Texas Health and Human Services Commission has formally announced that Be Well Texas, an initiative of the Be Well Institute on Substance Use and Related Disorders at UT Health San Antonio, has been selected to lead a major expansion of opioid use disorder and recovery support services across Texas.
Be Well Texas has been awarded funding to administer two key components of the state’s opioid response under a Needs Capacity Assessment initiative: medications for opioid use disorder treatment services and recovery support services.
This initiative is part of the broader Texas Targeted Opioid Response and Peer Support and Recovery Services strategy, aimed at reducing overdose deaths and building a lasting recovery infrastructure. The funding enables Be Well Texas and its partners across the state to expand treatment access, improve continuity of care and reach both rural and urban communities with life-saving services.
“We are honored by the trust placed in us by the Texas Health and Human Services Commission and grateful for their leadership in addressing the challenge of substance use across the state,” said Jennifer Sharpe Potter, PhD, MPH, founding director of the Be Well Institute and senior vice president for research at UT Health San Antonio. “This work would not be possible without the partnerships we’ve built with community leaders, providers and recovery organizations throughout Texas. Together, we are committed to expanding compassionate, evidence-based care for those affected by substance us.”
This award represents a unique collaboration between two state entities – HHSC and UT Health San Antonio – united by a shared vision: increasing access to high-quality, evidence-based and person-centered substance use services. As the lead agency, Be Well Texas will provide technical expertise, oversight and implementation support through a comprehensive network of treatment, recovery and provider engagement programs backed by the Be Well Institute’s deep clinical and public health experience.
“This is not just an expansion – it’s a continuation and amplification of the work Be Well Texas and its partners have been doing for years to scale effective, innovative models across Texas,” Potter said. “It reflects a growing momentum to ensure every Texan has access to care that works – wherever they are.”
Since 2021, the Be Well Texas initiative has served as a trusted partner in the state’s overdose prevention efforts, providing low-barrier clinical care, a robust statewide Provider Network, workforce training and substance use solutions at scale. The new funding will allow for even greater reach and integration of these services into Texas communities most in need.
The University of Texas Health Science Center at San Antonio (UT Health San Antonio) is one of the country’s leading health science and research universities. With missions of teaching, research and patient care, its schools of medicine, nursing, dentistry, health professions, graduate biomedical sciences and public health have graduated more than 45,000 alumni who are leading change, advancing their fields and renewing hope for patients and their families throughout South Texas and the world. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.
Stay connected with UT Health San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.
The Be Well Institute on Substance Use and Related Disorders at UT Health San Antonio is a statewide leader in advancing research, clinical care and education to address substance use and its impact on individuals, families and communities. The institute encompasses a range of initiatives, including the Be Well Clinic (offering in-person and telehealth services), Naloxone Texas (offering free statewide distribution of opioid overdose medication), the Center for Substance Use Training and Telementoring and a robust research arm dedicated to developing and scaling evidence-based solutions.
Be Well Texas, a flagship initiative of the Institute, provides compassionate, low-barrier access to treatment and recovery support through clinical care, a statewide provider network, workforce development and recovery infrastructure. Together, the institute’s programs expand access, reduce stigma and improve outcomes for Texans affected by substance use and related disorders.
SAN ANTONIO, Dec. 30, 2024 – Patients with opioid use disorder can reduce their days of opioid use and stay in treatment longer when using a smartphone app as supportive therapy in combination with medication, a new study by The University of Texas Health Science Center at San Antonio (UT Health San Antonio) shows.
The cohort study of 600 underserved patients found that those who chose to use the app – which combines contingency management behavioral therapy and recovery support from peers – and alongside medication, reduced their days of opioid use by 35% compared with those treated with medication only. Additionally, app users remained in treatment nearly 19% longer than those treated with medication alone.
“These findings suggest that augmenting medication for opioid use disorder with app-based contingency management may provide clinical benefits for underserved patients,” said Elise Marino, PhD, director of research operations at UT Health San Antonio’s Be Well Institute on Substance Use and Related Disorders. “Expanding the availability of app-based contingency management may contribute to decreasing the immense societal, economic and personal burden of opioid use.”
Marino is lead author of the study, titled, “Smartphone App-Based Contingency Management and Opioid Use Disorder Treatment Outcomes,” published in JAMA Network Open. The other authors also are with UT Health San Antonio’s Department of Psychiatry and Behavioral Sciences and the Be Well Institute.
A need to augment medication
Opioid use disorder continues to be a national crisis, contributing to substantial morbidity and mortality. Its annual societal cost in the United States hit $968.9 billion in 2018, the study notes.
Medication for opioid use disorder, or MOUD – including methadone, buprenorphine and naltrexone – is recognized as the only evidence-based treatment for the condition. This first-line treatment has been shown to significantly decrease opioid-related morbidity and mortality, and with consistent cost-saving benefits.
However, some patients still experience difficulties reducing opioid use and staying with their treatment, pointing to a need to augment MOUD. Many conditions benefit from dual treatment of medication and therapy. One therapy is contingency management, or CM, which provides financial incentives for accomplishing treatment goals.
This therapy traditionally has been delivered in clinics, with the goal of an opioid-negative finding from urine drug screens. While findings have been mixed, several reviews and studies have found that individuals treated with MOUD plus CM had better retention and fewer opioid-positive results from urine drug screens.
A long-standing limitation, however, is that patients are required to attend multiple in-person appointments per week for the therapy. With the recent COVID-19 pandemic, many were unwilling to make in-person CM visits. Additional access barriers, such as transportation, distance from the clinic and arranging child care, have supported other options like telehealth and leveraging new technologies.
There’s an app
One such technology is the WEconnect Health CM smartphone app. The app delivers evidence-based CM embedded in a recovery-oriented framework. In addition to providing substance-related behavioral targets, it permits patients to set daily goals that are personally meaningful, both substance use-related and otherwise, like attending a Narcotics Anonymous meeting, going for a walk or reading.
The app also includes a platform for tracking patients’ progress and payment, and provides encouragement for completing their daily goals. Additionally, WEconnect offers 1-to-1 peer support and online meetings facilitated by certified peers. In contrast to traditional CM, the app permits patients to make decisions regarding their own goals for treatment and to explore recovery through peer support services available anywhere and accessible outside of normal clinic hours.
For the new research, the scientists set out to evaluate whether augmenting MOUD with app-based CM is associated with fewer days of opioid use at the end of treatment and greater retention than treatment with MOUD only.
The retrospective cohort study, which refers to research that follows a group of people over time, used data from Nov.1, 2020, to Nov. 30, 2023, collected from opioid treatment programs across Texas. The cohort included 600 individuals aged 18 years or older who were uninsured or underinsured and who chose to receive MOUD only or MOUD plus CM delivered by the WEconnect smartphone app.
Those who chose to receive MOUD plus app-based CM reported a mean duration of 8.4 days of opioid use at the end of treatment compared with 12 days for those who chose to receive MOUD only. Retention analysis showed that patients who chose to receive MOUD plus app-based CM stayed with their treatment for a mean duration of 290.2 days, compared with 236.1 days for those choosing to receive MOUD only.
“These results are promising, and they highlight the potential importance of a patient’s decision to use app-based CM,” the researchers concluded. “Despite the challenges of engaging patients in other app-based interventions, adding recovery-oriented, app-based CM may be one way to enhance clinical care and meet the growing needs of historically underserved patients taking MOUD.”
UT Health San Antonio is a world-class research university, ranking at the top 5% among institutions globally for clinical medicine according to U.S. News & World Report. It is No. 12 in the world among universities for the impact of its discoveries – in normalized citation impact, which compares the number of citations its research receives per paper to the average for similar published work, a recognized core measure of research impact.
Smartphone App-Based Contingency Management and Opioid Use Disorder Treatment Outcomes
Elise N. Marino, Tara Karns-Wright, Matthew C. Perez, Jennifer S. Potter
First published: Dec. 2, 2024, JAMA Network Open
Link to full study: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827185
The University of Texas Health Science Center at San Antonio (UT Health San Antonio), a primary driver of San Antonio’s $44.1 billion health care and biosciences sector, is the largest academic research institution in South Texas with an annual research portfolio of $413 million. Driving substantial economic impact with its six professional schools, a diverse workforce of more than 8,500, an annual expense budget of $1.46 billion and clinical practices that provide 2.6 million patient visits each year, UT Health San Antonio plans to add more than 1,500 higher-wage jobs over the next five years to serve San Antonio, Bexar County and South Texas. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.
Stay connected with The University of Texas Health Science Center at San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.
The Be Well Institute on Substance Use and Related Disorders at UT Health San Antonio is a comprehensive, low-barrier system of care that provides compassionate, evidence-based treatment for substance use and related mental health concerns across Texas. Through its hybrid clinic offering virtual and in-person services, a statewide provider network of more than 140 community partners and wraparound services like peer recovery support, the institute reduces barriers to treatment and supports recovery. It also leads cutting-edge research to advance treatment and conducts workforce training to disseminate best practices. Funded by federal and state sources, the institute is dedicated to expanding access, reducing stigma and improving care for individuals and families affected by substance use disorders. Go to bewelltexas.org.
