Opioids Make it Harder, Not Easier to Work

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The twin goals of prescribing opioids to workers with a bad back or arthritis are to alleviate their pain and keep them employed.

But the use and abuse of opioids can cause poor memory, extreme drowsiness, and an inability to engage in normal social interactions – all of which limit workers’ ability to function. Opioids also have serious physical effects outside of the dependence itself.

The resulting detachment from the labor market, revealed in a new research study, calls into question any benefits the medications have.

Between 2012 and 2018, average employment declined by nearly 2 percent for every 10 additional opioid prescriptions per 100 adults in a county-sized area, the researchers found. Wages also dropped by 6 percent, indicating that the opioid users who do remain employed are less productive.

The painkillers had more permanent consequences, too, when workers, unable to cope, left the labor market for good. The rate of applications for federal disability benefits increased sharply in the areas with higher prescribing rates, according to the study funded by the U. S. Social Security Administration, which runs the disability program.

While this isn’t the first time opioids have been linked to lower employment levels, the impacts are larger and more robust than in past research, thanks to the data researchers had access to through a major national health insurance company.

The insurer has millions of members in both employer and individual health plans, and its data include prescriptions written by three out of every four U.S. physicians. This allowed the researchers to calculate detailed county-level prescribing rates while adjusting for differences in the members’ medical conditions and health care utilization.

The detrimental effects of going on opioids were clear.

For some people, alternatives to opioids such as physical therapy or non-addictive pain medications are effective. Less reliance on opioids “can not only improve patients’ health, but also work-related functioning and labor outcomes,” the researchers concluded.

To read this study, authored by Nicole Maestas and Tisamarie Sherry, see “Opioid Treatment for Pain and Work Disability Outcomes: Evidence from Health Care Providers’ Prescribing Patterns.”

The research reported herein was derived in whole or in part from research activities performed pursuant to a grant from the U.S. Social Security Administration (SSA) funded as part of the Retirement and Disability Research Consortium.  The opinions and conclusions expressed are solely those of the authors and do not represent the opinions or policy of SSA, any agency of the federal government, or Boston College.  Neither the United States Government nor any agency thereof, nor any of their employees, make any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of the contents of this report.  Reference herein to any specific commercial product, process or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply endorsement, recommendation or favoring by the United States Government or any agency thereof.