Alan B. Krueger

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 (LFP) during that same period.

In “Where have all the workers gone? An inquiry into the decline of the U.S. labor force participation rate” (PDF), Princeton University’s Alan Krueger examines the labor force implications of the opioid epidemic on a local and national level. 

Among other findings, the research suggests that:

  • Regional variation in opioid prescription rates across the U.S. is due in large part to differences in medical practices, rather than varying health conditions. Pain medication is more widely used in counties where health care professionals prescribe greater quantities of opioid medication, with a 10 percent increase in opioid prescriptions per capita is associated with a 2 percent increase in the share of individuals who report taking a pain medication on any given day. When accounting for individuals’ disability status, self-reported health, and demographic characteristics, the effect is cut roughly in half, but remains statistically significant.
  • Over the last 15 years, LFP fell more in counties where more opioids were prescribed. Krueger reaches this conclusion by linking 2015 county-level opioid prescription rates to individual level labor force data in 1999-2001 and 2014-16. For more on the relationship between prescription rates and labor force participation rate on the county-level, visit these maps.

In earlier research presented at the Boston Fed in 2016, Krueger found that nearly half of prime age men who are not in the labor force take pain medication on a daily basis, and that two-thirds of those men—or about 2 million—take prescription pain medication on a daily basis. In a 2017 follow-up survey to a subset of previous respondents, Krueger found that two-thirds of men not in the labor force and taking pain medication used Medicaid, Medicare, or Veterans Affairs health insurance to purchase prescription pain medication, with the largest group relying on Medicaid.

The LFP rate in the U.S. peaked at 67.3 percent in early 2000, and has declined at a more or less continuous pace since then, reaching a near 40-year low of 62.4 percent in September 2015. In recent years, the LFP rate among prime-age men has been notably low. In 2015, Italy was the only O.E.C.D. country that had a lower LFP rate of prime age men than the U.S.


Another interesting observation/possible correlation in what has happened in our country in the last decade.  There is DIGNITY in work, we’re all supposed to have something productive to do with our lives.  Not having this leads to a form of existential suffering.  This can lead to attempts to fill that “God shaped hole in our hearts” with things that don’t belong there.  We need to return to our spiritual roots as a culture & society!

Dr. Raymond Oenbrink
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