The Opioid Crisis Comes to the Workplace

The number of Americans dying at work due to overdoses is increasing at a rapid clip.

A man recovering from addiction to fentanyl patches at his home in Dickson, Tennesee, in June (David Goldman / AP)

Addiction to prescription pain medication has taken a staggering toll on America: According to one accounting, overdoses killed more people in one year than guns and car accidents combined.

Tens of thousands of Americans are dying each year from overdoses. It’s a grim trend that has touched just about every aspect of life—even, as the latest figures from the Bureau of Labor Statistics indicate, work. While traffic accidents, homicides, and suicides are still the top culprits of on-the-job fatalities, deaths related to addiction are increasing at a rapid clip. Last year alone, the number of workers who died at work because of drug- or alcohol-abuse-related incidents increased by more than 30 percent, to more than 200. While that number may seem small, it’s evidence of how rapidly the problem is growing—less than five years ago, fewer than 70 people died from overdoses at work.  Since 2012, the number of people dying from drug or alcohol related causes while on the job has been growing by at least 25 percent each year, according to the Bureau of Labor Statistics.

These deaths represent unspeakable individual tragedies. They also, in the larger picture, serve as a striking illustration of how America’s addiction epidemic is changing the landscape of work.

Over the past few years, economists have struggled to explain why so many people appear to be dropping out of the workforce. The most telling measure of that is the labor-force participation rate—which measures the percentage of the population that is employed or actively looking for work—which now sits around 62.7 percent. That’s low by historical standards. For example, between 1986 and 2001, labor-force participation grew fairly steadily, to between 65 and 67 percent. There are many theories about why this figure has been declining in the past decade or so: Automation, a lack of quality jobs, and an aging workforce are all thought to play a role. Still, the shortage of 25-to-54-year old workers—a group economists call “prime age” workers—particularly male ones, remains a big problem for the future of the labor market.

The economist Alan Krueger’s work has shown that there’s a striking relationship between these missing workers and increasing opioid addiction. According to an analysis done by Krueger, over the past 15 years, labor-force participation among prime-age workers has declined the most in U.S. counties where opioids prescriptions are the most plentiful. He is sure to mention that cause and effect aren’t clear: It’s hard to say whether addiction breeds joblessness, or vice versa. “Regardless of the direction of causality, the opioid crisis and depressed labor force participation are now intertwined in many parts of the U.S.,” Krueger writes.

The increasing number of on-the-job deaths due to addiction is evidence of this. While the opioid crisis is often cast as a problem that predominantly plagues the jobless, some studies show that around two-thirds of those who report abusing painkillers are still employed. On top of the devastating aftermath of injuries and deaths, this can also lead to a lot of workers not performing to their potential.

According to a survey from the National Safety Council, an advocacy and consulting group that studies safety practices, around 70 percent of employers have seen some impact of prescription drug use on their workers, from missed shifts and impaired work. And yet fewer than 20 percent of employers said that they felt prepared to deal with issues related to addiction, such as knowing how to broach the topic with workers or get them help. That’s evidenced by companies’ approach to addressing drug use: The companies that did report testing employees for drug use were much more likely to screen for marijuana (which has been legalized in many states) than synthetic opioids such as oxycodone or hydrocodone that are major contributors to the current wave of addiction and death.

According to the same survey, the vast majority of employers said that they would want to help workers struggling with addiction. And yet employers’ most common response to suspected drug use was that it is an offense that merits dismissal. As the country tries to address the crisis, it’s going to need to acknowledge how addiction touches many realms, including work and labor.