Boosting employment rate is unlikely to curb opioid use

April 17, 2018, Princeton University

Improving job prospects for people in economically depressed parts of the United States is unlikely to help curb the opioid epidemic, according to a study by researchers at Princeton University. On the other hand, opioid use may actually help some women—but not men—stay in the labor force when they would otherwise leave because of chronic pain.

To be clear, said Princeton economics chair Janet Currie—who conducted the study with Jonas Jin and Molly Schnell, two Princeton Ph.D. candidates in economics—there are many reasons that helping more people in depressed areas find work is a desirable goal. But the researchers found no definitive link between increasing rates of employment and decreasing rates of use.

The study appears on the website of the National Bureau of Economic Research.

Past research has found that higher rates of joblessness are correlated with higher rates of opioid prescriptions per capita. Some people have theorized that economic dislocation drives people to use opioids or, conversely, that becoming addicted to opioids makes people more likely to leave the labor force. However, the correlation doesn't prove that opioid use causes unemployment, or vice versa, Currie said. Rather, opioid use could be driven by some other factor, such as regional variation in doctors' prescribing practices.

"A distinguishing feature of the current epidemic of drug abuse is that many overdoses and deaths can be attributed to legal opioids that were prescribed by a physician," Currie said. "And many people who get opioids illegally first became addicted to legally prescribed opioids."

Currie and her colleagues used two primary types of data: records of opioid prescriptions filled at U.S. retail pharmacies from 2006 to 2014, and, for the same period, the U.S. Census Bureau's Quarterly Workforce Indicators, a jobs dataset that draws on a variety of government sources and covers about 95 percent of U.S. employment. These data let them calculate ratios of opioid prescriptions-to-population and employment-to-population for people of different ages and genders, and with different levels of education, in every U.S. county over time. Because the data encompassed the Great Recession and the uneven recovery that followed, they were able to observe a great deal of local variation in employment rates.

Next, they used sophisticated statistical techniques to test for causal relationships in either direction. Importantly, to calculate opioid prescription-to-population rates, they focused on prescriptions written for people age 65 and older. They reasoned that in places where doctors prescribe opioids more frequently, both working-age and elderly people would be more likely to receive such prescriptions. Because the prescriptions written for the elderly would be unlikely to affect employment rates, and vice versa, this technique helped them disentangle the two phenomena.

Examining their first question—whether a county's employment rates affect the number of opioid prescriptions—the researchers found that the answer was ambiguous. They saw some evidence that higher employment reduces opioid prescriptions among younger workers, but not older ones—and only in counties where education levels were above the national median. In general, the results didn't support the hypothesis that policies to boost employment would significantly diminish .

When the researchers looked at the data the other way around—that is, when they asked whether the number of opioid prescriptions in a population affects —they found a small positive relationship between opioid prescriptions and employment for women (but not for men). Specifically, they calculated that a 100 percent increase in opioid in a given county would lead to an increase in women's employment of between 3.8 and 5.2 percent. This finding, Currie said, suggests that "although they are addictive and dangerous, opioids may allow some women to work who would otherwise leave the ."

Overall, Currie said, the relationship between opioid prescribing and doesn't support any simple narrative, especially because many remain in the work force.

"This observation suggests that policy responses should be designed to take account of the fact that many addicts work," Currie said. "Therefore, treatment options that help people retain their connection to the labor market are likely to be necessary to effectively combat the epidemic."

Explore further: Doctors curbing first-time prescriptions for opioids

More information: The study, "U.S. Employment and Opioids: Is There a Connection?," appeared on the NBER's website in March 2018. As a working paper, it was not peer-reviewed or subject to the review by the NBER Board of Directors that accompanies official NBER publications.

Related Stories

Doctors curbing first-time prescriptions for opioids

April 13, 2018
(HealthDay)—Although the opioid epidemic continues to rage in America, promising new data show that first-time opioid painkiller prescription rates have slowed in recent years.

Effect of an opioid prescribing protocol on provider prescribing behavior

March 23, 2018
At the 47th Annual Meeting of the American Association for Dental Research (AADR), held in conjunction with the 42nd Annual Meeting of the Canadian Association for Dental Research (CADR), Chad Lowell Wagner, University of ...

Dentist group puts teeth in push to curb opioid painkillers

March 26, 2018
The American Dental Association wants dentists to drastically cut back on prescribing opioid painkillers.

Geography matters: Prescribing patterns for opioids in dermatology

February 7, 2018
A new study suggests that opioid prescribing is not widespread among dermatologists, but opportunities exist in concentrated areas to reduce their use. The study appears online Feb. 7 in JAMA Dermatology.

Doctors trained at lowest-ranked medical schools prescribe more opioids

August 14, 2017
Physicians trained at the United States' lowest-ranked medical schools write more opioid prescriptions than physicians trained at the highest-ranked schools, according to a study by Princeton University. The study suggests ...

Study reveals lack of self-awareness among doctors when prescribing opioids

March 27, 2018
As health providers struggle to curb the epidemic of opioid abuse, researchers at the University of Colorado Anschutz Medical Campus and the University of Massachusetts Medical School have found that 65 percent of emergency ...

Recommended for you

Text messaging tool may help fight opioid epidemic

April 17, 2018
A new automated text messaging service may curb opioid abuse and reduce the likelihood of relapse while also decreasing treatment costs, according to researchers at Washington University School of Medicine and Epharmix, a ...

Marijuana-based drug gets positive review from US agency

April 17, 2018
A closely watched medicine made from the marijuana plant reduces seizures in children with severe forms of epilepsy and warrants approval in the United States, health officials said Tuesday.

Post-surgical opioids can, paradoxically, lead to chronic pain

April 16, 2018
Giving opioids to animals to quell pain after surgery prolongs pain for more than three weeks and primes specialized immune cells in the spinal cord to be more reactive to pain, according to a new study by the University ...

Animal study suggests common diabetes drug may also help with nicotine withdrawal

April 5, 2018
In a mouse study, a drug that has helped millions of people around the world manage their diabetes might also help people ready to kick their nicotine habits.

20 years after Viagra, Pfizer seeks another miracle drug

April 1, 2018
It has been 20 years since Viagra was introduced, and Pfizer is still searching for another drug with as much earning power as the revolutionary blue erection pill.

Non-addictive pain medication changing therapy for substance use disorders

March 30, 2018
"It's not often that a psychiatrist gets to hear 'Doctor, you saved my life,' " said Ellen Edens, M.D., FW '09, assistant professor of psychiatry and associate fellowship director in addiction psychiatry. But she gets that ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.