Research Shows That Investing in our Workforce Can Help Counter the Opioid Crisis

Tuesday, August 14, 2018

With the help of our partners at the talent development firm Maher & Maher, IMPAQ International’s policy researchers have been studying the plight of communities and identifying some of the most effective solutions to combat the opioid crisis. This is the first of a four-part blog series. 

The Impact of the Opioid Crisis on the United States (U.S.) Labor Market

The White House Council of Economic Advisors estimates that the cost of the opioid crisis in 2015 was $504 billion.1 The crisis strains our economy in many ways, from lost lives and workplace productivity to inflating health care and criminal justice costs.

For example, the cost of hiring and maintaining employees is on the rise. Employer health insurance plans reflect this additional medical utilization. Opioid-abusing employees are estimated to have $8,600 more in health care expenses than their clean coworkers.2 Moreover, a third of all prescription painkillers paid for by employer-sponsored insurance plans are believed to be abused.3
While the media reports that the U.S. unemployment rate is at a low of 4 percent,4 this statistic fails to account for those marginally attached to the workforce, or those who are not actively looking for a job but have searched without success in the past year. The U-6 rate, which some argue measures true unemployment, includes this population and reveals that 8.1 percent of our workforce is not being utilized.5
Reports from the U.S. Department of Labor reveal that this high level of unemployment is not due to lack of opportunity. As of May 2018, there were over 6.6 million jobs available in the United States.6 In actuality, the United States is experiencing a labor supply shortage.
Businesses in the manufacturing industry have reported stalled growth due to an inadequate number of applicants able to pass pre-employment drug tests and to high employee turnover. As a result of their diminished workforce, entire communities are being overlooked for potential business investment opportunities.7

What Happened To These Missing Workers?

Alan Krueger, a Princeton economist, reports from a 2016 survey that 47 percent of working-age men not in the labor market consume pain medication daily. Of this group, 67 percent of them take prescription pain medications.8
Further research in 2017 reveals that a rise in opioid prescriptions from 1999 to 2015 can explain part of the fall in labor force participation during the same period. Krueger believes that opioids account for 20 percent of the labor decline for men and 25 percent for women.
Thousands of individuals have been unable to maintain employment with their addiction, likely leading to an increase in their substance abuse issues with the stress from lost wages and more unstructured free time.9

Employment: A Reliable Predictor and Support for Sobriety

Employment has been acknowledged as an important aspect and predictor of successful substance abuse recovery in multiple studies.11,12 Recent research reports a positive association between employment, longer-term heroin abstinence,13 and lower rates of relapse.14 Other studies also conclude that unstable labor markets are associated with a higher prevalence of substance use.15
Though employment and recovery are intertwined, many opioid abuse interventions fail to integrate these approaches. Sobriety, rather than stable employment, is typically the main goal of treatment.10
However, some innovative interventions are currently demonstrating that recovery programs with workforce development aspects can support drug abstinence and also better reintegrate people back into society. For example, one such successful program allowed participants to maximize their wages by providing opiate- and cocaine-negative drug tests.16


Promising steps are being taken to address the impacts of the opioid epidemic, however, evaluation of these programs must be prioritized as well.
Existing research has created a foundational understanding of the relationship between addiction recovery and employment, but further examination will expand our knowledge of opioid addiction, effective employment models, and the needs of different subpopulations.
Maher & Maher and IMPAQ International recognize the value of workforce rehabilitation programs, and we look forward to circulating the findings of our work, and that of others, to assist in the effort to end the opioid crisis in the United States.
1. The Underestimated Cost of the Opioid Crisis. (2017). Retrieved from
2. Saraiva, C., Laya, P. and Smialek, J. (2017). Opioids on the Job Are Overwhelming American Employers. [online] [Accessed 30 Jul. 2018].
3. O'Donnell, R. (2017). As opioids hit the workforce, employers are forced to improvise. Retrieved from
4. Labor Force Statistics from the Current Population Survey. (2018). Retrieved from
5. Table A-15. Alternative measures of labor underutilization. (2018). Retrieved from
6. Job Openings and Labor Turnover Survey. (2018). Retrieved from
7. Noguchi, Y. (2017). Opioid Crisis Looms Over Job Market, Worrying Employers and Economists. Retrieved from
8. Krueger, A. (2017). Where Have All the Workers Gone? An Inquiry into the Decline of the U.S. Labor Force Participation Rate. Brookings. Retrieved from
9. Schottenfeld, S., Pascale, R., & Sokolowski. (1992).  Matching services to needs: Vocational services for substance abusers. Journal of Substance Abuse Treatment, 9(1), 3-8. Retrieved from
10. Sherba, R., Coxe, K., Gersper, B., & Linley, J. (2018). Employment services and substance abuse treatment. Journal Of Substance Abuse Treatment, 87, 70-78. Retrieved from
11. Platt, J. J. (1995). Vocational rehabilitation of drug abusers. Psychological Bulletin, 117(3), 416-433. 
12. Melvin, A., Davis, S., & Koch, S. (2012). Employment as a Predictor of Substance Abuse Treatment. The Journal Of Rehabilitation, 78(4). Retrieved from
13. Hser Y, Hoffman V, Grella CE, Anglin MD. A 33-Year Follow-up of Narcotics Addicts. Arch Gen Psychiatry. 2001;58(5):503–508. doi:10.1001/archpsyc.58.5.503. Retrieved from
14. Castellani, B., Wedgeworth, R., Wootton, E., & Rugle, L. (1997). A bi-directional theory of addiction: Examining coping and the factors related to substance relapse. Addictive Behaviors, 22(1), 139-144. Retrieved from
15. Kerr, W. C., Kaplan, M. S., Huguet, N., Caetano, R., Giesbrecht, N., & McFarland, B. H. (2017). Economic recession, alcohol, and suicide rates; Comparative effects of poverty, foreclosure, and job loss. American Journal of Preventative Medicine, 52(4), 469-475
16. Holtyn, A., Koffarnus, M., DeFulio, A., Sigurdsson, S., Strain, E., & Schwartz, R. et al. (2014). The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: A randomized controlled trial. Preventive Medicine, 68, 62-70. Retrieved from