Project Description

Opioids, Pain and Absence

The Productivity Implications Of Substance Use Among U.S. Workers

The opioid epidemic has resulted in many analyses of the social and economic costs related to the problematic use of heroin and opioid pain relievers. The implications for employers as stakeholders often center on the risk of on-the-job accidents or difficulties in filling job vacancies in areas heavily affected by addiction and dependence. This may not only underrepresent the more pervasive productivity impact of lost work time, but also obscures the larger issues of chronic pain and substance use more generally. This study examines the use and abuse of prescription pain relievers and other substances and their association with absences from work.

Study highlights

  • One in three workers reported using pain relievers—the majority of whom used medication as prescribed. Less than one in 20 workers reported abuse of pain relievers or dependence. Less than 1% reported any heroin use.
  • Rates of alcohol abuse and dependence exceed the problematic use of pain relievers and other prescription medications. Any reported use of cocaine or methamphetamine was relatively uncommon (< 3% and < 1%, respectively).
  • Excess absences associated with pain relievers were greater than excess absences associated with any other substance. On average, non-problematic use of pain relievers was associated with 0.8 days of excess absences per month compared with non-users. The problematic use of pain relievers was associated with 2.0 absences, or 1.2 excess days per month compared with non-users.
  • Generally, excess absences associated with problematic use of substances are significantly greater than for non-problematic use.
  • Assuming a 20-day work month, the use of pain relievers was associated with a loss of about 1.3% of the monthly labor capacity of 1,000 workers. The non-problematic use of pain relievers accounts for nearly all (96%) of those losses.

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