The Opioid Crisis Is Taking a Toll on the American Labor Force

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Since the mid-1990s, the percentage of prime-age American men who don’t have a job — and aren’t looking for one — has risen dramatically. Over the same time period, per-capita sales of opioid painkillers in the United States has more than quadrupled. A new study suggests that there may be a relationship between these two facts.

In a paper published by the Brookings Institution on Thursday, Princeton economist Alan Krueger compares county-level data on opioid-prescription rates and labor-force participation, and finds that the more opioids were prescribed in a given region, the more likely that region was to have seen a significant decline in workforce participation.

The correlation was so dramatic, Krueger estimates that rising opioid prescriptions could plausibly account for one-fifth of the decline in the labor-force participation among American men between 1999 and 2015.

In previous research, Kreuger revealed that nearly half of all American men between the ages of 25 and 54 who were not in the labor force took pain medication on a daily basis. For two-thirds of those men, that daily pain medication was the kind that requires a prescription.

Critically, Krueger’s new research suggests that the counties where opioids are most widely prescribed aren’t, necessarily, places where the population is exceptionally ill or disabled. Rather, they are places where doctors seem to be exceptionally comfortable writing opioid prescriptions to treat pain.

Currently, America’s overall labor-force participation rate is 62.9 percent, unchanged from three years ago, and well below the 67 percent level that was typical in the late 1990s. Most of this decline can be attributed to benign factors — the retirement of the baby boomers, and a rising percentage of young Americans delaying work to pursue higher education. But the drop in participation by prime-age men has been sharp — right now, America has the second-lowest such rate among OECD countries — and very much malign: Krueger finds that prime-age men who have dropped out of the labor force are significantly less happy than their employed and unemployed peers.

There is still some ambiguity in Krueger’s findings. It’s possible that, to some extent, labor-force detachment increases demand for prescription opioids, rather than vice versa. Nonetheless, his paper offers compelling evidence that America’s painkiller habit isn’t just producing 100 overdose deaths in our country each day, but also impairing our economy’s capacity to grow.

Notably, the prescription opioid industry has achieved all this without actually reducing the levels of pain that Americans report.

“Despite the massive rise in opioid prescriptions in the 2000s,” Krueger notes in his paper, “there is no evidence that the incidence of pain has declined.”

The Opioid Crisis Is Taking a Toll On the American Workforce