The opioid epidemic is a source of deep national anguish in the United States: It now kills almost 100 Americans each day, more than motor vehicle accidents. President Donald Trump today officially declared the epidemic a national public health emergency. Although he hasn’t allocated any additional federal funding to address the crisis, the announcement could accelerate efforts at the federal, state, and local levels to identify and implement ways to combat it. As his administration strives to galvanize efforts, it would benefit from drawing on the growing body of research that examines the medical and economic origins and effects of the crisis.
Every part of the country is battling opioid addiction, but the worst-hit states include Ohio, West Virginia, and New Hampshire. The most recent definitive data on the prevalence of the problem comes from the National Survey on Drug Abuse and Health, which surveyed 51,200 Americans in 2015. Based on weighted estimates, 92 million, or 37.8%, of American adults used prescription opioids the prior year (2014); 11.5 million, or 4.7%, misused them; and 1.9 million, or 0.8%, had a use disorder. The epidemic is spreading so rapidly that it’s likely the numbers are higher now.
Researchers estimate the economic cost of the U.S. opioid epidemic may be as high as $80 billion a year, even excluding the economic value of a lost life. For those living with addiction, it’s very difficult to maintain regular employment: Nearly one-third of prime-working-age men who are not in the labor force take prescription pain medication on a daily basis, Princeton economist Alan B. Krueger found in 2016.
Building on this research, Krueger recently estimated that opioids could account for about 20% of the decline in labor-force participation from 1999 to 2015. This reduction in the proportion of working-age Americans who are employed is alarming. Krueger’s evidence: Participation in the labor force fell more in counties where relatively more opioid medication is prescribed. While this research isn’t definitive, the connection between opioids and economic productivity is certainly suggestive.