August 12, 2022

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Older Workers: Opioid Misuse and Employment Outcomes

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<div>What GAO Found Older adults (ages 50 and older) who reported having misused opioids were more likely to be unemployed or experience employment instability, according to GAO's analysis of the National Survey on Drug Use and Health data from 2015 through 2019. Higher percentages of those who misused opioids were male, unmarried, and did not have a college degree, compared with older adults who did not misuse opioids. Additionally, GAO conducted regression analyses and found that, when compared with all older adults who did not misuse opioids: older adults who misused opioids were an estimated 22 percent less likely to be in the labor force (either employed or actively seeking work); older adults in the labor force who misused opioids were an estimated 40 percent less likely to be employed; and employed older workers who misused opioids were twice as likely to have experienced periods of unemployment. The data did not allow GAO to determine causality as there are challenges to isolating the effect of opioid misuse from other factors that could affect older adults' employment experiences. Officials from selected local workforce agencies that provide services to help adults enter or re-enter the labor force said that the COVID-19 pandemic had mixed impacts on workers who had been affected by opioid misuse, including older workers. In particular, officials pointed out challenges and benefits to providing services in a virtual environment. For example, local workforce officials discussed how disruptions and changes to their operations during the pandemic made it difficult for adults with a history of opioid misuse to stay involved with their programs, and dampened some agencies' ability to enroll new individuals. Officials also said that their agencies' transition to virtual service delivery posed some challenges for program participants as they struggled to access and use the technology required to participate in workforce services like training. In contrast, officials also noted that virtual services offered flexibility for some participants, such as those who lacked reliable transportation. Why GAO Did This Study Opioid misuse has been a persistent problem in the U.S. In 2017, the Department of Health and Human Services (HHS) declared the opioid crisis a public health emergency. The Department of Labor (DOL) awarded grants to help address this crisis. While some research sheds light on the relationship between opioid misuse and workforce participation among workers of all ages, questions remain about the employment experiences of older workers affected by opioid misuse, as well as the experiences of workers during the COVID-19 pandemic. GAO was asked to explore recent trends among older adults and opioid misuse. This report examines (1) how individual characteristics and employment experiences differ between older workers who do and do not misuse opioids and (2) challenges that selected local workforce agencies identified in helping workers—including older workers—affected by opioid misuse during the COVID-19 pandemic. GAO analyzed HHS's Substance Abuse and Mental Health Services Administration's National Survey on Drug Use and Health data from 2015 to 2019 (the most recent 5 years of data available at the time of GAO's review); interviewed officials from eight local workforce agencies and four state workforce agencies that received certain DOL grant funding; and interviewed DOL and HHS officials. For more information, contact Thomas Costa at (202) 512-4769 or costat@gao.gov or Lawrance L. Evans, Jr. at (202) 512-8678 or evansl@gao.gov.</div>

What GAO Found

Older adults (ages 50 and older) who reported having misused opioids were more likely to be unemployed or experience employment instability, according to GAO’s analysis of the National Survey on Drug Use and Health data from 2015 through 2019. Higher percentages of those who misused opioids were male, unmarried, and did not have a college degree, compared with older adults who did not misuse opioids. Additionally, GAO conducted regression analyses and found that, when compared with all older adults who did not misuse opioids:

  • older adults who misused opioids were an estimated 22 percent less likely to be in the labor force (either employed or actively seeking work);
  • older adults in the labor force who misused opioids were an estimated 40 percent less likely to be employed; and
  • employed older workers who misused opioids were twice as likely to have experienced periods of unemployment.

The data did not allow GAO to determine causality as there are challenges to isolating the effect of opioid misuse from other factors that could affect older adults’ employment experiences.

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Officials from selected local workforce agencies that provide services to help adults enter or re-enter the labor force said that the COVID-19 pandemic had mixed impacts on workers who had been affected by opioid misuse, including older workers. In particular, officials pointed out challenges and benefits to providing services in a virtual environment. For example, local workforce officials discussed how disruptions and changes to their operations during the pandemic made it difficult for adults with a history of opioid misuse to stay involved with their programs, and dampened some agencies’ ability to enroll new individuals. Officials also said that their agencies’ transition to virtual service delivery posed some challenges for program participants as they struggled to access and use the technology required to participate in workforce services like training. In contrast, officials also noted that virtual services offered flexibility for some participants, such as those who lacked reliable transportation.

Why GAO Did This Study

Opioid misuse has been a persistent problem in the U.S. In 2017, the Department of Health and Human Services (HHS) declared the opioid crisis a public health emergency. The Department of Labor (DOL) awarded grants to help address this crisis. While some research sheds light on the relationship between opioid misuse and workforce participation among workers of all ages, questions remain about the employment experiences of older workers affected by opioid misuse, as well as the experiences of workers during the COVID-19 pandemic. GAO was asked to explore recent trends among older adults and opioid misuse.

This report examines (1) how individual characteristics and employment experiences differ between older workers who do and do not misuse opioids and (2) challenges that selected local workforce agencies identified in helping workers—including older workers—affected by opioid misuse during the COVID-19 pandemic.

GAO analyzed HHS’s Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health data from 2015 to 2019 (the most recent 5 years of data available at the time of GAO’s review); interviewed officials from eight local workforce agencies and four state workforce agencies that received certain DOL grant funding; and interviewed DOL and HHS officials.

For more information, contact Thomas Costa at (202) 512-4769 or costat@gao.gov or Lawrance L. Evans, Jr. at (202) 512-8678 or evansl@gao.gov.

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