From 1999 to 2015, there were 4.1 million fewer people in the workforce because of opioid addiction, the latest research to show that drug use is having a profound effect on the U.S. economy.
A study from the American Action Forum finds that the loss of these employees, ages 25 to 54, and their productivity cost the U.S. economy $702.1 billion, or just under $44 billion per year.
"It's a pretty big drag on the U.S. economy," said Ben Gitis, director of labor market policy at the American Action Forum, a right-leaning think tank.
The number of people who are not working because they are dependent on opioids has grown each year since 1999. Nearly 1 million people in their prime earning years were absent from the workforce in 2015 because of opioid addiction, according to the study.
Gitis' research showed that the loss of work hours caused the economic growth rate to slow by 0.2 percentage points over the 16-year period. The average growth rate was 2 percent during that time frame, he said. But "estimates suggest had these workers been in the labor force and not addicted to opioids, the growth rate would have been 2.2 percent," he said.
Opioids killed more than 42,000 people in 2016, according to the Centers for Disease Control and Prevention.
"Of course the opioid crisis is a major health issue. The overdose fatalities by themselves suggest how big of a problem it is," Gitis said. "But it's also a major constraint on our economy."
Gitis' research builds off that of Princeton University economist Alan Krueger, who estimated in a paper last year that the increase in painkiller prescriptions could have caused a 20 percent decline in workforce participation among men and 25 percent among women. Krueger noted that areas with the highest rate of opioid prescriptions registered huge drop-offs in the number of people in the workforce.
Gitis took national data from 1999 and 2015 and, using Krueger's assumptions, extrapolated how many people would have been in the workforce if not for opioid addiction.
The analysis shows that more work hours were lost for women - 6.4 billion - than men, who were down 5.7 billion hours from 1999 to 2015.
The trend has persisted even as the economy has rebounded and employers in some parts of the country are struggling to fill vacancies. In some places, employers say it is difficult to find people who can pass a drug test. Some companies are even doing away with them.
"It's something we hear companies talk about all the time, not being able to have workers pass drug tests and being unable to simply get workers to apply because they know they won't pass the drug test," Gitis said. "It was really important that we get a sense of what the magnitude of this could be."