GRIM MILESTONE Ray Donovan, chief of operations of the Drug Enforcement Administration, stands in front of “The Faces of Fentanyl” wall — displaying photos of some of the 69,000 Americans who died in 2020 of a fentanyl overdose — at the DEA headquarters in Arlington, Virginia.
And while it is difficult to
calculate just how much drug use has caused absenteeism, tardiness, and stretches of disability, the connection is strong, as Edwards’ experi- ence suggests. “We’ve been writing
about this for years, but it doesn’t seem to get a lot of traction,” said Dr. Gary Franklin, a research pro- fessor at the University of Washington who served as the medical director of the state’s Department of Labor and Industries. “People have not realized
how much opioids contrib- ute to disability and lost pro- ductivity, and I don’t know if anyone has been able to put a number on that.” In 2021, more than
107,000 people died from drug over- doses, a nearly 15% increase from the year before and more than double the grim tally recorded in 2015, according to the Centers for Disease Control and Prevention. All told, overdose deaths are seven
times higher than they were in 1999. Synthetic opioids such as fentanyl,
which law enforcement has tracked from labs in China along trafficking routes through Mexico on the south- ern border, are now driving the over- dose epidemic. The CDC attributed 69,000 over-
dose deaths to synthetic opioids in 2020, 82% of the nation’s total that year. Heroin overdoses, meanwhile, went up 7% in 2020 to 13,000, accord- ing to CDC figures. That means synthetic opioids and
heroin dwarf cocaine and metham- phetamines, although totals for both of those have been rising for a decade and often cause overdose deaths in combination with opioids. The National Institutes of Health
shows fewer than 5,000 people were killed by cocaine alone and fewer than 10,000 by what it dubs “psychostimu- lants,” which include methamphet- amines, in 2020. Less precisely, economists since at
least 2017 have pegged the epidemic’s annual dollar cost at over $1 trillion in terms of deaths, law enforcement, and “lost productivity.”
The CDC attributed 69,000 overdose deaths to synthetic opioids in 2020, 82% of the nation’s total that year.
But the amount attributable to
deaths — $550 billion of the $1 tril- lion — is largely conjecture because it is derived from actuarial estimates for lost years; for example, the decades cut from what would have been a normal working life for someone who fatally overdoses at age 45. Then there is the less lethal side
of the equation — one that workers and employers grapple with daily. Roughly 8% of workplace fatalities in 2020 — 388 of 4,786 — were attributed to “unintentional overdose from non- medical use of drugs,” according to the Bureau of Labor Statistics. A post on a neighborhood social
media platform asking about opioids’ dire impact in the workforce unleashes a barrage of firsthand horror stories. Homeowners speak of an inability
to hire handymen, painters, landscape workers, and the like. “If I’m lucky enough to have an
employee that can pass a [urine analy- sis], the chances of them doing so after the first check is slim,” wrote a tree
surgeon in suburban New Orleans. But he acknowledged some truth
to the stories of workplace abuse of prescription opioids, mentioning laborers’ common habit of relying on increasingly higher-milligram dosages of pain pills like Percocet. A National Safety Council study
reported that more than 75% of U.S. employers have been affected by employees’ prescription drug use, according to congressional testimony, and the NIH estimates some 3 mil- lion Americans, including workers, are addicted to opioids. The CDC does keep a tally, although
it hasn’t publicly updated the grim numbers on its “opioid dashboard” since 2017. The figures from that year show that the biggest economic hit has come in the Appalachian states around the Ohio Valley and in New England, two regions where opioids and syn- thetics have torn a hole through the workforce.
Establishing opioid disorder costs
is complicated by the fact much of it is now driven by black market synthetic drugs like fentanyl and can no longer be tracked through prescriptions. To date, the nation’s prime age
labor workforce has not recovered to where it was at the beginning of 2020 and is now the lowest it has been in 45 years. The hit has been especially pro- nounced among older adults, accord- ing to the Government Accountability Office.
Middle-aged white men have long comprised the single biggest group of annual overdose deaths, but between 2015 and 2020 the rate among Black men skyrocketed to 54.1 per 100,000, topping white men’s 44.2 per 100,000, according to the Pew Research Center. Dr. Andrew Kolodny, a faculty
member at Brandeis University whose practice has specialized in opioid addiction, sums up the crisis: “Rather than economic conditions leading to overdose deaths it’s really the other way around — it’s not the economy driving them to death, it’s the opioid crisis affecting the economy.”
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