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1 1 (December 10, 2018)

handle is hein.crs/govycg0001 and id is 1 raw text is: Conresioa ReerhIevc December 10, 2018 The Opioid Epidemic and the U.S. Labor Market Some Members of Congress have expressed strong concerns about the societal costs of the opioid epidemic, including its potential to adversely affect the U.S. economy. Efforts to quantify the annual economic costs of opioid abuse and dependence produce estimates in the tens of billions of dollars, of which workforce losses-decreased productivity, missed days of work, and premature death- account for a substantial share. Opioid abuse could further generate labor force costs-directly or indirectly-if it affects labor force participation decisions and unemployment. A small body of research has explored correlations between opioid abuse and these indicators, but it remains unclear whether the opioid epidemic is a driver or an outcome of recent workforce trends or an indicator of other underlying factors. The discussion that follows looks at studies that have examined the relationship between recent labor market patterns and opioid misuse (i.e., illicit opioid use and misuse of prescription drugs, meaning use in any way other than as prescribed). It is important to bear in mind, however, that some opioids have a legitimate medical use and may improve both labor market participation and worker productivity. For example, findings from a recent study of county-level opioid prescribing rates and employment suggest that prescription opioids allowed some women to work who otherwise would not. In addition, some research suggests that untreated pain is associated with lower worker productivity. An overview of the recent opioid epidemic is provided first and followed by a discussion of how it may have interacted with the labor market. The Recent Opioid Epidemic Opioids-drugs derived from the opium poppy or those emulating the effects of opium-derived drugs-bind to opioid receptors in the body that are essential in the regulation of pain and emotions. Opioids have been used by the medical community to treat pain for centuries, but they also have tremendous potential for abuse and addiction. For this reason, stakeholders in the United States, such as the federal government and the medical community, generally sought to minimize the use of opioids outside of palliative care for much of the 20th century. Beginning in the 1970s and 1980s, advocacy groups, believing that pain was being undertreated, sought to increase the use of opioids for pain management. By the 1990s, advocacy efforts-including the pain as the fifth vital sign campaign-successfully shifted the treatment approach to chronic pain (particularly non-cancer pain) to include more opioids This movement was bolstered by the 2001 introduction of new pain management standards by the Joint Commission-an independent, non-profit accreditation body for health care organizations. Included in these standards were PE1.4: pain is assessed in all patients and RI.1.2.8: patients have a right to appropriate assessment and management of pain. Occurring alongside this shift in pain treatment philosophy was the 1996 release and aggressive marketing of OxyContin, a high-dosage formulation of the opioid oxycodone. The drug was pitched as an effective but non- addictive pain reliever based on its slow-release formula, despite early reports that it was just as addictive as other opioids and easily diverted from intended use. Between 1991 and 2011, opioid prescriptions tripled. As prescriptions increased, so did diversion. A study by the National Institutes of Health found that the rates of nonmedical use of prescription opioids increased from 1.8% to 4.1% of the adult population between 2001-2002 and 2012-2013. In 2002, roughly 1.5 million people reported pain reliever abuse or dependence in the previous year. In 2012, that number was over 2 million. Over that same time, the number of people abusing heroin doubled-from 240,000 in 2002 to over 480,000 in 2012. In 2016, over 2 million Americans qualified for an opioid use disorder diagnosis. Figure I. Opioid-Related Deaths, 1999-201 7 12 10 0 V 0 Source: Centers for Disease Control and Prevention (CDC). Notes: All opioids includes deaths that include at least one of the following International Classification of Diseases (ICD- 10) codes: T40.0-T40.4, or T40.6. ICD- 10 codes for the individual opioid lines are heroin (T40.1), natural and semi-synthetic opioids (T40.2), and synthetic opioids (T40.4). Estimates are age-adjusted. Since the onset of the epidemic in the late 1990s, rates of opioid overdose deaths have also increased significantly. Driven largely by prescription opioid pain relievers, opioid overdose deaths tripled from 1999 to 2014. In 2017, the age-adjusted rate of opioid overdose deaths in the United States was nearly 15 per 100,000 people-up from 2.9 per 100,000 in 1999. https:/crsreports.congress go

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