State report: Opioids drive people out of the labor market

A strong correlation exists between opioid prescriptions per capita and a healthy labor market. The Coffee County Drug Court Foundation battles the issue, offering resources to locals who fight addiction. On Monday, Mike Lewis, executive director of the foundation, shows the classroom used to help clients of the drug court find and keep jobs. Linsey Vanover, a coordinator for the foundation, prepares for one of the classes.

A strong correlation exists between opioid prescriptions per capita and a healthy labor market, according to several state agencies.

The Economic Report to the Governor of the State of Tennessee, completed by the University of Tennessee Boyd Center for Business and Economic Research in   2018, outlined the effect drug addiction is having on the labor market of the state. While a new 2019 economic outlook report has been published, the 2018 study focused more closely on the effects the opioid crisis has had on the economy.

Most discussions of the opioid epidemic have focused on adverse health consequences including addiction, overdoses and mortality. However, one aspect of the problem that has not received adequate attention, the 2018 report states, is the potential consequences of that epidemic for the labor market.

The findings indicate that prescription opioids are driving people out of the labor market.

Studies show that a 10 percent reduction in per capita opioid prescriptions would lead to an additional $825 million in income for Tennesseans from enhanced labor market participation.


Local efforts

The Coffee County Drug Court Foundation has battled the issue for years, offering resources to locals fighting addiction.

According to Mike Lewis, executive director of the drug court foundation, plenty of job opportunities exist; however, those who are addicted fail to pass drug tests and keep their jobs.

“The employment agencies here work really hard to get people employed,” Lewis said. “A lot of times, people who are in active addiction won’t show up for job interviews or they won’t stay on the job because they are either using drugs, can’t pass a drug screen or they are busy seeking drugs.

“Our treatment programs work to help people by holding them accountable. We follow up to make sure people keep appointments with the employment agencies and that they show up to job interviews,” Lewis continued. “We even check with employers to make sure our clients are at work, acting responsibly and passing the drug test here.”

People trapped in the cycle of opioid addiction tend to exchange normal values related to self-worth, family and employment for drug-seeking behavior, which is not conducive for healthy living, positive employment or maintaining a healthy family environment, said Lewis.

“Our treatment programs provide intensive accountability paired with substance abuse treatment to help guide people out of the culture of addiction into a healthy world of living responsibly,” Lewis said. “This process enables people to reconnect with the values many of us consider normal, which include self-worth, family and employment.”

The local programs have seen success, said Lewis.

“We have a high rate of success of people who not only get jobs but are able to retain them for months and even years at a time, where before they wouldn’t keep a job for more than a few weeks,” Lewis said. “They are excited to be hired full time and earn benefits.”


Opioid crisis in the state

Nationwide, the number of opioid prescriptions written has grown dramatically, from 76 million in 1991 to 245 million in 2014, according to the 2018 UT report.

Addictions, overdoses and deaths have seen dramatic increase. In 2015, opioid-related deaths rivaled the number of deaths from car accidents.

The rapid growth in opioid abuse is due to a variety of factors, including marketing efforts and the introduction of purportedly nonaddictive extended-release drugs. OxyContin, introduced in 1995, is one of the drugs that was marketed as being non-addictive, according to the report.

Tennessee has had extensive experience in dealing with the opioid crisis, with the state ranking second in the nation in 2012 for opioid prescriptions dispensed per capita.

In 2016, a significant share of individuals in Tennessee Department of Mental Health and Substance Abuse Services treatment facilities had opioid-related abuse problems.

Opioid-related hospitalization costs have been estimated at $442.6 million per year, and TennCare costs at $76.9 million annually.

There is clear evidence of a strong correlation between opioid prescriptions per capita and measures of labor market health.


Finding a solution

Eliminating opioids entirely is not a realistic option because many individuals find therapeutic benefits from the use of the medications, the report states. The goal should be to find the right balance for a drug that produces benefits for some but high costs for others.

A starting point may be focusing on the prescribing behavior of high-prescribing physicians in Tennessee who are a primary source of opioids.

A range of other mitigation efforts will be required, from information campaigns to increasing the availability and quality of treatment programs, according to the report.

The report was prepared by the Boyd Center for Business and Economic Research of the University of Tennessee, Knoxville, in cooperation with the Tennessee Department of Finance and Administration, Tennessee Department of Economic and Community Development, Tennessee Department of Revenue and Tennessee Department of Labor and Workforce Development.

Elena Cawley may be reached via email at