American communities that have been hollowed out by the ongoing opioid epidemic are only now starting to come to grips with the scope of the damage. While the death toll is staggering, the hideous truth is that those killed by opioids represent the tip of an iceberg that penetrates into the very core of our country.
Across the country, policymakers are scrambling to address the opioid epidemic on a daily basis: how to respond to double-digit overdoses; how to treat growing numbers of citizens addicted to opioids; how to help children affected by their parent’s addiction. These are tough, demanding and reoccurring problems for so many town, county, and state officials. What’s worse, is that the demands required to solve these problems sometimes obscure the deeper, underlying issues of a nation that’s been flooded by pain pills.
A new study suggests that the increase in opioid use may account for a 20-percent drop in male participation in the labor force. Although the relationship is not yet fully understood, the consequences appear to be widespread, long-term and devastating.
The opioid pills that have ruined so many lives did not just fall from the sky. Big Pharma’s opioid spree brought them billions of dollars in profit. It was the result of a deliberate strategy that relied on misleading patients and doctors. As individuals, families and communities struggle to recover, it’s important that they understand just how deep the damage is.
Where Have All the Workers Gone?
Last October, renowned economist Alan Krueger published a study that stunned the public. Titled “Where Have All the Workers Gone?”, Krueger investigated the decline in America’s labor force participation rate – that is, the proportion of the total population who are working or actively searching for work. This number is important, and since the beginning of this century, it has been dropping. In September 2015, the rate was 62.4 percent, the lowest number in almost 40 years.
When Krueger surveyed people who were not in the labor force (NLF) – people who are neither employed nor looking for employment – he found the widespread use of painkillers. This proved to be especially true of prime-age men (25-54-years-old). For this group, Krueger found that:
“Nearly half of prime age NLF men take pain medication on a daily basis, and in nearly two-thirds of cases they take prescription pain medication.”
Because of the dangerous and addictive nature of prescription pain medication, these numbers startled researchers. Krueger continued to investigate this connection, and this fall, he presented follow-up research that suggested:
“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.”
So, what does this mean? It’s difficult to draw a straight line between cause and effect, but as Krueger notes, “Regardless of the direction of causality, the opioid crisis and depressed labor force participation are now intertwined in many parts of the U.S.”
As the picture continues to come into view, it remains deeply unsettling to think about the long-term consequences of so many prime-age people out of the workforce. For policymakers, the thought that so many people are unable to work only compounds the problems they face as they seek to rebuild.
Certain Counties Hit Harder by Over-Prescription
Another finding in Krueger’s work indicates a “clear regional pattern to opioid prescription rates and drug overdoses.” Looking at the maps illustrating his research, one can identify the counties that have been crippled by the interrelated problem of falling labor participation and increased opioid prescription.
These differences in prescription patterns, Krueger notes, have little to do with the health of patients. Citing the Center for Disease Control (CDC), Krueger asserts that, “Health issues that cause people pain do not vary much from place to place, and do not explain this variability in prescribing.” If it’s not the health of the patients that changed prescription patterns, then what was it?
A Deliberately Misleading Campaign Fueled Over-Prescription
According to the CDC, the amount of opioids prescribed per person was three times higher in 2015 than it was in 1999. It’s important to note, as Krueger does, that in 2015, 33,000 people died from opioid overdose – more than twice the number of Americans murdered in homicides.
For literally thousands of years, humans have been aware of the addictive and powerful side-effects of opiates. So why would doctors suddenly, in the mid-90s, start prescribing these drugs in record amounts?
That opiates are somehow safe enough to warrant prescribing them in such volume is clearly a farce. The reason that doctors changed their prescription practices is that they were peddled a fake story by pharmaceutical companies like Purdue, Teva and Endo — companies that were looking to sell more drugs and boost their bottom lines. These nefarious campaigns proved wildly profitable for the companies and left a horrific trail of devastation across the country.
Holding Big Pharma Accountable – Communities Make Their Case
Most recently, Tacoma, Washington and the state of New Mexico joined the wave of opioid litigation that seeks to hold these pharmaceutical companies responsible for fueling an epidemic that has caused so much damage.
According to the Financial Times, at least 30 states, cities and counties have already or are now taking steps to file similar lawsuits accusing pharmaceutical companies of downplaying opioid risks in order to boost profits. National law firms like Simmons Hanly Conroy are leading the charge, representing communities in Cape Cod, MA, and a handful of counties across New York.
New Mexico’s Attorney General, Hector Balderas, explains his reasoning for joining the fight against opioid makers and distributors:
“New Mexico continues to endure the most catastrophic effects of the opioid crisis, all while major out of state corporations make billions in profits at the expense of our families and communities.”
For Balderas, it’s obvious these companies need to step up and answer for the epidemic they created. In Tacoma, like so many other cities across the United States, resources are running thin and the problems are only worsening. City officials estimate that at least half of their city’s growing homeless population is addicted to opioids. In the lawsuit, they allege:
“Prescription opioids have not only helped to fuel the homeless crisis, but have made it immeasurably more difficult for the City to address.”
These issues might be impossible to resolve immediately; certainly it’s going to take time, resources and a lot of courage on the part of the cities, counties and states that are reeling from the epidemic. The President has declared the opioid crisis a national emergency. While this frees up funding at a crucial time, it will hardly address the long-term problems that policymakers will no doubt confront in the coming decades.
Widespread addiction and homelessness have profound economic consequences. Krueger’s work helps illuminate the scope of the problem – not that it’s any comfort – and he is quick to remind the public that even his figures “likely understate the actual proportion of men taking prescription pain medication given the stigma and legal risk associated with reporting taking narcotics.”