Economic Impact of Opioid Use Disorder in Missouri

Editor’s note
The executive summary of this brief appears below. To view the PDF of the entire brief, please select the “Download this publication” button.

Mark C. White
Associate Extension Professor. Labor and Workforce Development

Executive summary

This brief supports University of Missouri Extension’s Substance Abuse and Mental Health Services Administration (SAMHSA) Rural Opioid Technical Assistance (ROTA) grant. This grant enables the creation of recovery-friendly communities and workplaces throughout the state of Missouri. Educating employers and community leaders about the challenges and consequences of opioid use disorder is an important step in developing Recovery-Friendly communities and workplaces. This brief contributes to these efforts by estimating the economic impacts of workers lost to opioid use disorder in several of Missouri’s key industry sectors.

Although the opioid crisis presents a very clear societal challenge, it raises many concerns for the labor force. Between 1999 and 2018, almost 450,000 Americans died from both prescription and illicit opioid overdoses, and the majority of these deaths occurred among people of prime working age. Economist Alan Krueger found that almost half of the prime- aged men not in the labor force took pain medication daily, and approximately two-thirds of those taking daily pain medication were using prescription drugs.

The loss of these workers from the labor force — often resulting from injury and subsequent use of pain medication — has real implications for the U.S. and Missouri workforce. This is especially true for industries (e.g., construction, extraction, healthcare, etc.) that often involve physical work, and where higher injury rates increase the likelihood of opioid prescriptions and use. This report examines the employment consequences and economic impacts of diminished labor force participation in several of Missouri’s key industry sectors most affected by opioid use disorder — agriculture, mining, utilities, construction, manufacturing, wholesale trade, transportation and warehousing, and healthcare.

Key findings

The American Action Forum (AAF) built on Krueger’s research by examining the impact of opioid use disorder on labor force participation, and specifically doing so at the state level. The AAF study found that between 1999 and 2015, opioid use disorder reduced the Missouri labor force by 2.7 percent and 3.4 percent amongst prime aged (25 to 54) male and female workers, respectively. When applied to employment data, these findings allow us to estimate the number of Missouri workers lost to opioid addiction. From these estimates, we can determine the direct economic impacts (in terms of lost jobs, labor income, output, etc.) for the industries most affected by opioid use disorder. The resulting impacts vary by industry sector:

  • The impacts on the manufacturing sector are characterized by significant job loss and far reaching economic impacts. Based on 2019 employment levels, the reduced labor force participation brought about by opioid use amongst prime age manufacturing workers directly costs the Missouri manufacturing sector roughly 5,500 jobs. However, the impacts of these lost jobs extend beyond the manufacturing sector:
    • The Missouri economy loses an estimated 14,744 total jobs (5,518 direct, 4,801 indirect, and 4,425 induced) due to opioid-related workforce losses in the state’s manufacturing workforce; more succinctly — for every 10 manufacturing jobs lost to opioid use disorder, 16.7 jobs are lost elsewhere in the Missouri economy.
    • These job losses have also led to an additional loss of $934.5 million in labor income, $1.56 billion in value added (0.5% of Missouri's 2019 State GDP), and
    • $4.36 billion in output.
    • Wholesale trade, and to a somewhat lesser extent construction and transportation, are other sectors where reduced labor force participation resulting from opioid use results in significant job loss and broad reaching economic impacts.
  • In some instances, the economic impacts of diminished labor force participation caused by opioid use disorder are characterized more by job losses than broader reaching economic impacts. Overall, the total job losses resulting from opioid-related loss of workers in the healthcare industry are comparable in scale to the manufacturing sector. The Missouri economy loses an estimated 15,243 total jobs (9,812 direct, 2,411 indirect, and 3,020 induced) due to opioid-related workforce losses in the state’s healthcare workforce, based on 2019 employment levels:
    • A greater relative share of the total job losses is borne by the healthcare sector and the ripple effect of these job losses are not as pronounced as in manufacturing. For every 10 healthcare jobs lost to opioid use disorder, 5.5 jobs are lost elsewhere in the Missouri economy.
    • Due to the scale of the healthcare sector, these job losses also result in an estimated loss of $854.3 million in labor income, and $1.17 billion in value added (0.4% of Missouri's 2019 State GDP).
    • In addition to healthcare, agriculture is another sector where the most pronounced economic impact is the loss of workers.
  • There are also sectors that employ fewer workers — relative to, for instance, manufacturing or healthcare — but the loss of employment, wages and output resulting from opioid-related job losses significantly ripple throughout the economy. Sectors that exhibit these kinds of impacts include utilities and mining:
    • In total, the Missouri economy loses an estimated 693 jobs (232 direct, 192 indirect, and 269 induced) due to the opioid-related workforce losses in the state’s utilities workforce. That means that for every 10 utilities jobs lost to opioid use disorder, 20 jobs are lost elsewhere in the Missouri economy.
    • Similarly, Missouri’s mining sector is relatively small, but for every 10 mining jobs lost to opioid use disorder, 16.4 jobs are lost elsewhere in the Missouri economy. Moreover, for every $100 of lost labor income in the mining sector, the Missouri economy loses more than $250 elsewhere.

Overall, this analysis shows the broad-based consequences of opioid use on Missouri’s workforce and economy. Mitigating the negative impacts of opioid addiction requires more than just individuals trying to recover and fully participate in the workforce, and more than employers finding and retaining workers. Rather, opioid use disorder has wide reaching economic impacts, and affects entire industries and the economy at large.

As a result, efforts to address these challenges must reflect these wide-reaching impacts — not only in the actions taken — but also by the people and organizations involved. Creating Recovery Friendly Workplaces are an important step in mitigating the impacts of substance use disorder. Recovery Friendly Workplaces foster a workplace culture that promotes employee safety, health, and well-being through support for managers and employees, and by providing education and recovery resources related to the challenges surrounding substance use disorder. Establishing and sustaining Recovery Friendly Workplaces through collaboration with many partners across the state can positively impact Missouri’s workforce and ultimately Missouri’s economy.