Effects of Opioid Addiction on the Labor Market

Research shows that prescription opioid use leads to decreased participation in the labor force and higher rates of unemployment, as well as significant increases in workplace injuries. What can employers do to curb these negative impacts?

Prescription pills may be negatively impacting labor productivity and unemployment rates in the United States, according to new research done by economists at the University of Tennessee, Knoxville.

The study — published in The Journal of Human Resources — examined county-level data across the U.S. and found a 10 percent increase in prescription opioid-use per capita. This rise in pain pill prescriptions led to a 0.56 percentage point decrease in labor force participation rates, according to the data.

Matthew Harris, assistant professor in UT’s Boyd Center for Business and Economic Research, co-author of the study and co-author of the paper, “Prescription Opioids and Labor Market Pains,” said that the surge in prescription opioids might explain up to half of the labor force participation decline since 2000.

Effect on the Workplace

Despite their risks, opioids are often the most effective treatment for pain following surgery or injury. Managing pain can reduce time away from work. When used in the short-term and low doses, opioids are not likely to affect an employee’s productivity.

However, when prescription drug use progresses to a substance use disorder, data shows that employees miss nearly 50 percent more work days than their colleagues, which leads to a reduction in productivity.

Additionally, the National Safety Council (NSC) warns that employees using opioids should not participate in “safety-sensitive” work due to the drugs’ impairing side effects. In early 2015, the NSC conducted a poll of 1,014 adults. Of those polled, 427 people reported having been prescribed opioids in the last three years. Nearly half of the people who admitted to taking opioid painkillers within that time also reported participating in potentially risky behaviors — including going to work, driving a vehicle and operating heavy machinery — while under the influence.

Another 2016 study by the Workers Compensation Research Institute found that between 65 to 85 percent of employees injured on-the-job were taking prescription opioids. The study examined 264,000 claims from 25 states.

Effect on the Economy

A recent study measuring the causal effects of opioids on the labor force found that the data was consistent for both rural and nonrural counties — both labor markets felt the negative impacts of prescription opioids.

Additionally, the study found that the effects were felt most strongly in counties with higher labor force participation rates and lower unemployment rates. This data suggests that prescription opioid damage has already occurred in areas with low labor force participation.

The study began after one of Harris’ colleagues spoke with local business leaders and determined that there were more jobs available than applicants to fill them. The researchers then wondered if those vacancies were somehow connected to the ongoing opioid epidemic.

Mike Lewis, executive director of the drug court foundation, reported to Manchester Times that people with addictions often don’t show up for job interviews, can’t pass drug tests or fail to keep jobs as a direct result of their addiction. Likewise, results from the study found that a 10 percent reduction in opioid use per capita in the state of Tennessee could effectively boost residents’ income — and thereby the economy — by an estimated $800 million per year.

Drug and Alcohol Treatment Keeps People Employed

Researchers concluded that considerable funding and increased focus on treatment therapy is needed to address the prescription opioid epidemic affecting U.S. labor markets.

Even though an estimated 80 to 90 percent of people misusing opioids could benefit from treatment, they are not getting it, reported the U.S. News & World Report in 2016. This phenomenon is primarily caused by lack of availability, affordability and access to drug treatment programs.

The Affordable Care Act attempted to alleviate some of the disparity in health care services for mental health and substance use disorders by requiring insurance benefits for addiction to be equal to all other covered general medical conditions. However, with a possible repeal on the horizon, adequate coverage for addiction treatment might once again pose a problem.

To make matters worse, while the unemployment rate in the United States is considerably low at 3.7 percent, a significantly higher percentage of people in recovery — 9.2 percent — are involuntarily unemployed. These numbers — along with an in-depth discussion related to “recovery friendly” workplaces — were included in a 2018 article in The Washington Post, which presented data from a 2017 study by the Recovery Research Institute at Massachusetts General Hospital.

A recovery friendly workplace is a workplace willing to overlook the stigma surrounding employees who have struggled with addiction. Instead, time away from work for treatment and the resulting gaps in employment are treated the same as any other medical or health-related leave.

Research shows that working can help people with substance use disorders stay committed to recovery. Working gives many people hope, which can deter relapse. According to the article, it makes good business sense for companies to hire and retain people who have misused drugs rather than to continue to try to fill slots with new employees from a narrowing job-applicant pool.

For example, Belden, an electric wire factory in Richmond, Indiana, started a first-of-its-kind drug treatment program that guarantees participants a job with the company after treatment is complete, according to an NPR report.

The program began in early 2018 after company executives decided it was the best way to handle the influx of job applicants — needed to keep up with production efforts in the small, rural area — who were failing pre-employment drug screens. This program has also helped Belden retain existing employees who “slipped-up.”

Belden called in a New York-based addiction specialist, Mitch Rosenthal, to help design the program. Rosenthal said the program’s success hinges on a double-win for its participants, in that they can see themselves succeeding in work as they succeed in therapy. While there is a high cost involved, the returns can be worth it for many companies like Belden that are limited to smaller applicant pools and increased production demands.  

Improved Accessibility and “Whole Patient” Care

Addiction treatment can now be done online or via teleconferencing. This therapy method eliminates access problems due to transportation, distance or availability of addiction treatment specialists in certain rural regions.

Teleconferencing and other convenience-added measures for better access to quality mental health and substance abuse treatment can mitigate repeated requests for time away from work, with addiction treatment and monitoring that can essentially take place during a lunch break.   

Comprehensive treatments for prescription opioid abuse and addiction include:

• Medication-assisted treatment (MAT)
• Cognitive behavioral therapy (CBT)
• Residential rehabilitation and outpatient or inpatient treatment

The National Institute on Drug Abuse (NIDA) recommends a “whole patient” approach that involves a combination of medicines and behavioral counseling. Effective addiction counseling can change a person’s attitudes and behaviors related to drug use and help re-establish healthy life skills. NIDA research shows that patients who receive medication intended to counteract addiction during the recovery process are more likely to remain in therapy than patients who are not treated with medication-assisted treatment.

Employer and Employee Responsibilities

The Americans with Disabilities Act (ADA) governs policies related to an employer’s inquiry of an employee using prescription medications. Such questions, according to the ADA, must be job-related and consistent with the needs of the business.

However, employers can make their employees aware of the risks and hazards of using opioid painkillers and performing certain jobs while impaired. Additionally, employers can implement policies that prohibit the use of certain drugs when working or completing specific tasks. There should also be clearly defined consequences for not complying with such policies.

Employers should be on the lookout for troubling behaviors at work that might indicate prescription opioid misuse or addiction. Opioid painkillers can compromise employee and workplace safety and lead to higher workers’ compensation claims. Employers can play an important role in reducing risks and helping employees seek treatment.

Signs of employee drug abuse might include:

• Patterns of poor work quality or quantity
• Attendance problems (i.e., frequent absences or tardiness)
• Difficulty interacting with coworkers or clients

The CDC also recommends that employers establish an Employee Assistance Program (EAP). EAPs can offer information, drug screening, therapy and referral services for treatment to employees with prescription opioid addictions.

Recovery from addiction starts with high-quality treatment. If you or someone you know lives with a substance use disorder, consider calling The Recovery Village. Reach out to a representative today for more information.

Editor – Megan Hull

Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more