Prescription Opioid Misuse and Labor Supply: Does the Level of Misuse Matter?

Over the past two decades, misuse of prescription painkillers in the U.S. particularly opioids increased rapidly, to the point that in 2011 the CDC labeled the problem an "epidemic". Research investigated the negative health effects of prescription opioid misuse (POM), but little research examined the associations between POM and labor supply. This study investigates the associations between POM and labor force participation and, conditional on being in the labor force, employment. This study merged cross-sectional data from the 2010-2014 National Survey on Drug Use and Health for individuals aged 26 to 64 years old. The analysis examined any misuse, ‘infrequent misuse’ (1 – 199 days), and ‘frequent misuse’ (200 – 365 days) over past year. Prevalence estimates for labor force participation found that 84.8 % of individuals with any opioid misuse were in labor force compared to 81.2% of individuals with no misuse. Roughly, 84.1% of infrequent misusers were in labor force compared to 64.7% of frequent misusers. Unadjusted logistic regressions indicate a positive association between any misuse and labor force participation, but adjusted logistic regressions indicate no association. Both adjusted and unadjusted logistic results found frequent misusers to be less likely in the labor force compared to infrequent misusers. Prevalence estimates for employment indicate that 89.6% of individuals with opioid misuse were employed relative to 92.5% of individuals with no misuse. Roughly, 89.7% of infrequent misusers were employed compared to 81.8% of frequent misusers. Unadjusted and adjusted logistic results indicate a negative association between any misuse and employment, and no significant differences between infrequent and frequent misusers with respect to employment.

The associations between POM and labor force participation and employment are not consistent throughout the opioid misuse spectrum. In the unadjusted logistic regression, labor force participation was positively associated with past year POM while frequent misusers were less likely to be in the labor force relative to infrequent misusers. Moreover, employment was negatively associated with past year POM whereas there were no differences in odds of employment between frequent and infrequent misusers. Focusing now on the multivariable analysis, the results indicate no association between past year POM and labor force participation; frequent misusers were less likely to be in the labor force compared to infrequent misusers. On the other hand, we found a negative association between past year POM and employment while there were no statistically significant differences between types of misusers and employment.

Understanding the labor supply behavior of POMs is vital in formulating treatment and policy proposals that build upon work incentives. This study is among the first to use standard definitions of work status to enhance our understanding of the associations between POM and labor force participation and employment.

These findings should be interpreted with caution. The data is self-reported with general validity and reliability issues. The surveys are cross-sectional, and thus, not appropriate to make causal inferences. Finally, we did not control for the potential endogeneity of POM in the labor supply specifications to avoid biases that might be associated with using weak instruments.