Research associates use of painkillers with one-fifth of recent shrinkage in size of U.S. workforce

Brookings Institution map; click on it to see a much larger version.

Princeton University economist Alan Krueger found in 2016 that almost half of prime working-age (25-54) men who are not in the labor force take pain medication daily, two-thirds of them by way of prescriptions. He has taken a closer look at the data, and says increased use of opioids could account for one-fifth of the recent shrinkage in the American workforce—as defined by the rate of participation in the labor force, the proportion of people employed or looking for work.

Krueger's new paper and data, published in the Fall 2017 edition of Brookings Papers on Economic Activity, "suggests that the increase in opioid prescriptions from 1999 to 2015 could account for about 20 percent of the observed decline in men’s labor-force participation during that same period, and 25 percent of the observed decline in women’s labor-force participation," Fred Dews reports for the Brookings Institution. "Over the last 15 years, the labor-force participation rate fell more in counties where more opioids were prescribed."

Labor-force participation has been declining for about 15 years, "reaching a near 40-year low of 62.4 percent in September 2015," Dews notes. "The participation rate of American women had fallen from the top group of OECD countries to near the bottom," according to the international Organization for Economic Cooperation and Development.

Krueger suggests that while much of the decline comes from the aging population "and other trends that pre-date the Great Recession (for example, increased school enrollment of younger workers), an increase in opioid prescription rates might also play an important role in the decline, and undoubtedly compounds the problem as many people who are out of the labor force find it difficult to return to work because of reliance on pain medication," Dews writes.

But is the trend more because people on painkillers are less likely to work, or because people not working are more likely to be on painkillers? “Regardless of the direction of causality, the opioid crisis and depressed labor-force participation are now intertwined in many parts of the U.S,” Krueger writes.

The research reveals regional differences in medical practices. "A 10 percent increase in the amount of opioids prescribed per capita in a county is associated with a 1 percent increase in the share of individuals who report taking a pain medication on any given day, holding health and other factors constant," Dews reports.