Posts Tagged "opioids"

medication

Opioid Use Higher for Disability Applicants

With the nation still in the midst of an opioid crisis, a new study provides the first estimate of opioid use among people who apply for disability.

One out of every four applicants used opioids in 2017 – below the peak in 2012 but still significantly more than in the general population, according to researchers at Mathematica and the U.S. Social Security Administration.

And the researchers may be underestimating the extent of opioid use. Their data come from Social Security’s disability application forms. The forms ask applicants to list their prescriptions, including opioids taken for musculoskeletal pain such as a bad back, as well as their non-prescription drug use, and the stigma around use and abuse may encourage underreporting.

To estimate opioid use required creating a database because none existed. The researchers mined the text fields in each disability application using machine learning to find information about opioid use and then entered the information into the database.

Some interesting demographic trends emerged from the study. Opioid use is most prevalent in middle age, at around 30 percent of disability applicants in their 40s and 50s. “This is notable,” the researchers said, because if Social Security grants their requests for benefits, they “may remain on the [disability rolls] for 25 years.”

In a breakdown by education levels, the biggest opioid users had attended college but didn’t get a degree. Women’s use exceeded men’s throughout the study’s 10-year period, mirroring the population as a whole. And a state-by-state breakdown shows that applicants’ opioid use fell across the nation during that time. But Alabama, Arkansas, Michigan, and Nevada still had particularly high rates in 2017. …Learn More

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Automation of Jobs Fuels Overdose Deaths

The rise in opioid addiction has created an epidemic of drug overdose deaths in the United States. But what increases the risk that people develop the disorder in the first place?

Automation of the U.S. economy turns out to be a contributing factor, as workers lose good jobs to industrial robots and despair about being disengaged from the labor force, conclude researchers at the University of Pennsylvania and Yale in a study funded by the U.S. Social Security Administration.

Manufacturing jobs, often in unionized industries, used to be a major route to the middle class. But millions of factory jobs disappeared as U.S. companies moved operations overseas. Compounding the job losses, corporate employers began installing robots in their remaining domestic operations. Automation was blamed in one study for eliminating more than 700,000 jobs and causing wage stagnation in the 1990s and early 2000s.

Prior research has connected the flight of manufacturing to increasing deaths from drug overdoses. Now, the new study specifically ties technology – measured as an increase in robots per 1,000 workers – to the increase in overdose deaths.

The men who are most affected by the rise of automation are in their prime working years, and they are concentrated in more industrialized areas. Automation accounted for nearly one in five of their overdose deaths in manufacturing counties. For women, automation was responsible for one in 10 overdose deaths in manufacturing counties. …Learn More

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Opioids and Workers with Disabilities

Everyone knows about the dangers of opioid addiction. But prescription opioids can be useful to people with physical disabilities if they ease their pain so they can hold down a job.

A new study finds that this might be occurring in certain parts of the country where more opioid prescriptions are written.

But this finding is at odds with other evidence in the study that these same areas also see increased enrollment in Social Security’s disability program. A possible increase in employment is puzzling, since this program has strict limits on how much people can earn.

Adibah Abdulhadi at the University of Wisconsin reconciled her seemingly contradictory findings this way: some people with disabilities, including some who rely on opioids, may be working more – but if they are, they’re mostly in part-time jobs.

Under Social Security’s benefit rules, workers on disability can keep their benefits if their earnings do not exceed the program limit of $1,260 per month in 2020. A part-time job can be a way to stay below this income threshold.

The impact of opioid use on the labor market was analyzed on a county-by-county basis. In counties with higher opioid prescription activity, the unemployment rate fell by eight-tenths of 1 percentage point over the study’s four-year period, though this result wasn’t conclusive.

The decline was also confined to the most urban counties, which tend to have more robust job markets than rural areas and also more employers that can accommodate workers’ disabilities. Strikingly, the higher prescription activity was also linked to an increase in part-time employment.

While the impact of prescription activity on employment is inconclusive, the impact on disability is clear. “Greater use of opioids consistently leads to greater use” of disability insurance, Abdulhadi said.

To read this study, authored by Adibah Abdulhadi, see “The Effects of Opioids on Labor Market Outcomes and Use of Social Security Disability Insurance.”Learn More

Despair Grips Lower-Paid White Workers

Book Cover of Deaths of DespairLong before COVID-19 upended our world, the lives of lower-paid, less-educated workers had already been coming apart.

“It’s the other epidemic, but it’s an epidemic that’s been occurring under the radar for a long time,” Anne Case said in her keynote address for the annual meeting of the Retirement and Disability Research Consortium, which was held online early this month.

Case, a Princeton University economist, was referring to the findings from her seminal work on the deterioration in financial well-being and rising death rates among white, non-Hispanics without a bachelor’s degree. Case, along with her husband, Angus Deaton, also at Princeton, have just published a book on their research, “Deaths of Despair and the Future of Capitalism.”

The deaths of despair they refer to are due to drug addiction, liver disease from alcoholism, and suicide. In writing this book, they are shining a spotlight on a phenomenon affecting people who no longer have a voice, in part because labor unions, once powerful advocates, have declined.

In 2018, some 158,000 white adults of all ages without a college degree died from addiction, alcoholism and suicide, according to Case and Deaton’s research – more than double the number in 1992 and on par with COVID-19 deaths to date.

But the death rate is just the tip of an iceberg of woe that includes an increase in physical pain, declining mental health, and a loss of a sense of self, Case said.

One disturbing trend is the relatively recent phenomenon of rising suicides among white women without a bachelor’s degree. Although suicides among their male counterparts are still much higher, women’s suicides in recent years have been increasing at roughly the same pace.

What is at the root of this despair? Case provides economic explanations, including a long-term decline in men’s wages and in the percentage who are employed. However, economics is inadequate to explain the despair. …Learn More

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Opioid Abuse Tied to Where People Live

In 2019, the U.S. Attorney’s Office in northern Oklahoma detained one doctor charged with operating a pill mill that prescribed opioids to addicts for the simple reason that he presented “a danger to our community.”

While mental illness and unemployment are familiar culprits in the opioid crisis sweeping the country, the environment that people live in – including the prevalence of unscrupulous doctors – is actually important as well.

That’s one conclusion in a new study that found that people are more likely to become addicts if they move from an area with a relatively low level of prescription opioid abuse to a high-abuse area.

The research looked at more than 3 million people on federal disability insurance (DI) – a group that uses opioids at much higher rates than the general population. More than half of DI recipients are prescribed opioids in a given year. And since they are covered by Medicare, the researchers had access to the prescription records for Oxycontin, Vicodin, and morphine.

To gauge the impact of moving to a new location, the researchers created an index that estimated the extent of prescription opioid abuse in each U.S. county. The index took into account several factors, including the amount of opioids prescribed to patients and their use of multiple prescribers.

When DI recipients moved from a county at the low end of this index – the 25th percentile – to the high end – the 75th percentile – their rate of prescription opioid use increased nearly 5 percent, according to the study conducted for the Retirement and Disability Research Consortium.

People with a prior history of prescription opioid use were at particularly high risk of prescription opioid abuse if they moved to a high-use area. …Learn More