The economic cost of the opioid crisis reaches far beyond those suffering from this disease. Communities, business owners, and industries are impacted when people die from opioid use disorder through the permanent loss of workforce and tax base. As thousands die each year because of this disease, the economic impacts will continue to be far reaching. However, with interventions to prevent addiction , increase availability of naloxone,  and expand access and utilization of treatment we are making progress to save lives and reduce the negative impact on the economy.

Impacts of the Opioid Epidemic on the Pennsylvania Workforce
The opioid epidemic has had widespread economic consequences, including effects on unemployment, unscheduled worker absenteeism and lost lifetime productivity due to early mortality. Unemployment and absenteeism have direct, near-term consequences to employers and employees, reducing business productivity, employee earnings and economic output that generates state, local and federal tax revenue. Deaths from opioid overdoses have sustained economic consequences from the permanent loss of workers who would have made positive contributions to our economy over the span of their working lives. A recent report by the Society of Actuaries estimated that lower productivity among workers and early opioid-related mortality accounted for 55 percent of the total economic burden of the opioid epidemic in the United States.
This portion of the Opioid Data Dashboard presents the estimated impacts of the opioid epidemic on productivity and the workforce in Pennsylvania. Below are the estimated total wage losses due to opioid use disorder, including wage loss estimates specifically associated with time in the hospital due to opioid misuse and premature death caused by fatal opioid overdoses. Each of these wage loss estimates also includes associated lost state income tax revenue, quantifying the opioid epidemic’s fiscal impacts on the Pennsylvania state economy.

Estimated Total Wages Lost Due to Opioid Use
Opioid misuse and opioid use disorder can lead to unscheduled worker absenteeism, reduced productivity, hospitalizations that cost days of work, unemployment, and even exits from the labor force. On average, substance use disorder has been estimated to reduce total per-person productivity by 17 percent. Because wages are tied to productivity, annual lost wages in Pennsylvania were estimated by multiplying the 17 percent reduction in productivity associated with substance use disorder by the estimated number of people with substance use disorder in each county in Pennsylvania and by the annual average wage in each county.
The map below displays the annual estimated total wage losses associated with opioid use disorder by county. Scroll over each county to also see the estimated lost state income tax revenue associated with these lost wages, which is calculated as 3.07% of the foregone wages. Trend analysis by age and gender is also available for this population.

Estimated Lost Wages Due to Hospitalization for Opioid Use
Individuals hospitalized for opioid overdoses and related complications of opioid misuse are not able to work during their hospital stays–and, in many cases, for an extended period after. Using Pennsylvania Health Care Cost Containment Council (PHC4) data, wage losses associated with hospitalization were estimated for working-age Pennsylvania residents (ages 21-64 admitted to an in-state hospital for drug poisoning or use and with a diagnosis of opioid use disorder). The number of days spent in the hospital was used to estimate duration of work missed—with single-day hospital stays of at least four hours counting as a day of lost work. Wage losses were estimated using county-level average weekly wages based on the patient’s county of residence and the quarter-year that hospitalization occurred. Wages were pro-rated by the proportion of days hospitalized (e.g. if a patient was hospitalized for three days, the wage loss was estimated as 3/7 of the average weekly wage in their county). Drill down on the graph to see trends by gender. Trends by county and age  are also available for this population. Also available are the days of hospitalization from which these productivity loss estimates are calculated by gender and age.

Estimated Lost Lifetime Wages Due to Fatal Opioid Overdose
Fatal overdoses caused by opioids can cost years, if not decades, of productive employment. Annual estimates for lost lifetime wages due to premature opioid-related mortality were estimated by calculating lost lifetime earnings following fatal overdose (assuming retirement at age 65) based on the ages and counties of residence of the individuals who fatally overdosed. Wages were assumed to be the annual county average earnings reported by the Bureau of Labor Statistics, with 1 percent annual growth (not including inflation), and were discounted annually by 2 percent to adjust to present value. The map below shows the sum of all of those lost lifetime earnings due to fatal opioid overdose annually for each county. Annual lost lifetime wages are available for this population. 

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Supported by the Aetna Foundation, a national foundation based in Hartford, Connecticut that supports projects to promote wellness, health and access to high-quality health care for everyone. The views presented here are those of the author and not necessarily those of the Aetna Foundation, its directors, officers, or staff. 
The Pennsylvania Department of Health and the University of Pittsburgh School of Public Health conducted the analysis for the results presented in the Community Impacts section of the PA Opioid Dashboard.