Working Paper: NBER ID: w30110
Authors: Abby E. Alpert; Steve Schwab; Benjamin D. Ukert
Abstract: There is significant interest in understanding the labor market consequences of the opioid epidemic, but little is known about how opioid use impacts on-the-job productivity. We analyze the impact of opioid initiation in the emergency department (ED) on workforce outcomes in the Military using linked medical and administrative personnel data for active duty service members from 2008 to 2017. Exploiting quasi-random assignment of patients to physicians in the ED, we find that assignment to a high-intensity opioid prescribing physician increases the probability of long-term opioid use and leads to subsequent negative effects on work capacity, job performance, and productivity. We also analyze the mechanisms underlying these negative workforce outcomes. While opioid use does not negatively affect measures of physical job performance, we find large increases in behavioral problems which lead to disciplinary actions and job separation.
Keywords: opioid use; employment outcomes; military; labor market; productivity
JEL Codes: I18; J21
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| high intensity of opioid prescribing (I11) | long-term opioid use (I12) |
| opioid prescription (L42) | job performance (M51) |
| opioid initiation (Y20) | job promotion (J62) |
| opioid initiation (Y20) | job demotion (J62) |
| opioid initiation (Y20) | adverse actions (K41) |
| opioid initiation (Y20) | job separations (J63) |
| opioid initiation (Y20) | disciplinary-related discharges (Y80) |
| opioid prescription (L42) | long-term opioid use (I12) |