Princeton Economist: Nearly Half Of Working Age Men Not In The Labor Force Take Opioids Daily

Esteemed Princeton professor and former Obama White House economist Alan Krueger is back with yet another prediction about why Americans, particularly men between the ages of 25-54, suddenly no longer have any interest in working.  In his report, entitled "Where Have All The Workers Gone? An Inquiry Into The Decline Of The U.S. Labor Force Participation Rate," Krueger ponders the data below which reveal that the labor force participation rate among men, aged 25-54, started dropping around 1965 and has been steadily declining ever since.

Of course, it couldn"t possibly have anything to do with stagnant real wages or soaring entitlements that have provided massive, and increasing, disincentives to work over the past several decades. 

No, after spending months, or maybe even years, running very complicated regressions that your simple mind could never possibly understand, Krueger would like for you to know that it"s the growing opioid epidemic that is forcing men to sit on their couches all day rather than look for work.  Here"s a summary of his findings from the Brookings Institute:

The increase in opioid prescriptions from 1999 to 2015 could account for about 20 percent of the observed decline in men’s labor force participation (LFP) during that same period.

In “Where have all the workers gone? An inquiry into the decline of the U.S. labor force participation rate” (PDF), Princeton University’s Alan Krueger examines the labor force implications of the opioid epidemic on a local and national level.

Among other findings, the research suggests that:

• Regional variation in opioid prescription rates across the U.S. is due in large part to differences in medical practices, rather than varying health conditions. Pain medication is more widely used in counties where health care professionals prescribe greater quantities of opioid medication, with a 10 percent increase in opioid prescriptions per capita is associated with a 2 percent increase in the share of individuals who report taking a pain medication on any given day. When accounting for individuals’ disability status, self-reported health, and demographic characteristics, the effect is cut roughly in half, but remains statistically significant.

• Over the last 15 years, LFP fell more in counties where more opioids were prescribed. Krueger reaches this conclusion by linking 2015 county-level opioid prescription rates to individual level labor force data in 1999-2001 and 2014-16. For more on the relationship between prescription rates and labor force participation rate on the county-level.

Krueger also provided this very helpful map proving that opioid abuse is highly correlated to unemployment.  Of course, it couldn"t possibly be the case that opioid abuse is the result of high unemployment and the associated depression that goes along with it...no, the opioid abuse definitely came first.

So, what is Krueger"s solution to help reverse the seemingly perpetual decline in labor force participation rates?  If you guessed "Obamacare" then you"re absolutely right...and unfortunately, no, that is not a joke...here is the excerpt from page 38 of Krueger"s paper:

Third, addressing the decades-long slide in labor force participation by prime age men should be a national priority. This group expresses low levels of SWB and reports finding relatively little meaning in their daily activities. Because nearly half of this group reported being in poor health, it may be possible for expanded health insurance coverage and preventative care under the Affordable Care Act to positively affect the health of prime age men going forward.

And while we would never presume to be smart enough to question the very thorough, impartial research of a Princeton economist, we do wonder whether it"s in any way relevant that labor force participation rates seemingly started to decline in 1965...

...at exactly the same time that welfare spending started to surge?

It"s probably just a coincidence.

Krueger"s full report can be reviewed here:

Inside The Opioid Crisis That You're Not Allowed To See

Via StockBoardAsset.com,

Earlier this month, U.S. Attorney General Jeff Sessions unveiled a plan to go after doctors and pharmacies suspected of healthcare fraud by oversubscribing opioids. America’s opioid epidemic killed 33,000 people in 2015 making it the worst drug crisis in our history. Last week, President Donald Trump declared the opioid crisis a national emergency allowing the executive branch to direct funds towards treatment facilities and supplying police officers with naloxone.

As a socio-economist on the front lines of the opioid crisis in Baltimore, Maryland, I am about to take you through an opioid experience like you’ve never seen before. We’re going to travel into the inner city of Baltimore and interview current and former addicts of opioids and heroin. Some of these individuals used heroin 15-minutes before the cameras started rolling.

These individuals have never been given the chance to tell their story until now. Baltimore’s mainstream news is not allowed to share this because it breaks the narrative that everything is awesome. It turns out that Baltimore could have the largest methadone clinic in the United States called Turning Point Clinic. Each of the interviewees are current and past patients of the clinic and speak very negatively about it. A similar description of Baltimore is heard from each of the interviewees of a hellacious city with decades of deindustrialization, drug abuse, and violent crime.

In the first video, three women who are current or past addicts of opioids tell the story of clinics, doctors, and pharmacies flooding the street of Baltimore with opioids. Gina mainly speaks about the Turning Point Clinic - how a preacher who operates the facility went from “nothing to now wearing $1000 gators, flying private jets, and driving Bentleys”. As described by one of the women, it looks like ‘zombie-land’ outside of the clinic.

In the second video, Gina speaks about her addiction to opioids and how she overcame the troubles through a strong-will. The next women to speak is Wanda, who is currently in pain management at Turning Point Clinic and speaks about how the opioid crisis is destroying America’s youth. I then ask the question about record number of homicides in Baltimore, and Wanda says opioids are a big part of that.

In the third video, ‘John Doe’ shot up on heroin 15-minutes before giving us the interview. He is an active patient at the Turning Point Clinic and describes it to be the largest methadone clinic in the United States with 6k-10k patients per day. The illegal activity and the corruption around this clinic is highlighted in the video via ‘John Doe’ statements, along with truth bombs that will not disappointment.

Conclusion

We now have an understanding that opioids are big business in the hood. You’re not allowed to know about this, because only a select few in our society are allowed to prosper from it. It’s unfortunate that drug trade is the most prevalent type of good flowing around low income areas across the United States. We wouldn’t expect nothing else after 50-years of deindustrialization and the bottom 90% of Americans left to rot.

America’s inner cities have to change or the collapse of an empire is on the horizon. Doesn’t help when 96 million Americans are out of the workforce.

The Opioid Crisis Is Even Worse Than We Thought

America’s opioid epidemic is now killing more than 100 people every day, fueling a public-health crisis that’s straining state and local resources – even forcing at least one Pennsylvania coroner to increase his freezer capacity to make room for all of the bodies.

And according to one recently published study, the epidemic may be killing more Americans than previously believed. The study, published in the American Journal of Preventative Medicine, suggests that certain states may have underestimated the rate of opioid- and heroin-related deaths, skewing national death totals by more than 20%. In 2014, the most recent year covered by the study, the rate of opioid-related deaths was, in reality, 24% higher than the official count.   

Meanwhile, data from the CDC released Tuesday show that drug overdose deaths peaked in the third quarter of last year, with 19.7 for every 100,000 people, compared with 16.7 in the same period the year before.

Trump signed an executive order in March creating a national opioid commission to recommend strategies for combating the crisis. The commission, which is being led by New Jersey Gov. Chris Christie, has already urged Trump to declare a national emergency to deal with the opioid crisis. A final list of recommendations is expected by Oct. 1.

"We will fight this deadly epidemic and the United States will win," Trump said during a press briefing on Tuesday called to address the opioid epidemic. "We will win. We have no alternative."

Discrepancies arise when death certificates don’t specify the class of drug, or the specific drug, responsible for a given death. In certain states, the corrected opioid-related death rates were significantly higher than what had previously been reported. In Pennsylvania, which had the highest discrepancy, the real rate was more than double the official rate, with deaths per 100,000 rising to 17.8 from 8.5. Indiana, Alabama, Louisiana and Kentucky were also guilty of “substantially” underreporting death rates.

According to government data, Pennsylvania had the 32nd highest reported opioid mortality rate and the 20th highest reported heroin mortality rate in the country. But the study found that nearly half of opioid and heroin-related deaths weren’t counted. When the data were corrected, Pennsylvania’s ranking rose to the fourth-highest opioid mortality rate, and seventh-highest heroin mortality rate.

The corrected data also yielded more “coherent” geographic patterns by eliminated discrepancies caused by quirks in how fatality data are collected in each state.

“Specifically, the corrected death rates demonstrate that opioid involved mortality was concentrated in the Mountain States, Rust Belt, and Industrial North—extending to New England—and much of the South, whereas heroin deaths were particularly high in the Northeast and Rust Belt, but less so in the South or Mountain States. The results were less apparent when using reported rates, because high mortality in states such as Pennsylvania and Indiana were concealed by a frequent lack of specificity about drug involvement on death certificates.”

The study, which analyzed data on drug-related deaths collected between 2008 and 2014, found that heroin-related deaths increased more rapidly in most states, except for Montana, North Dakota, South Dakota and Nebraska. Nationwide, the increase in heroin-involved mortality was underestimated by around 18%, while the change in opioid-related fatalities was negligible.

Drug-overdose deaths in 2015 killed 52,000 Americans, more than gun homicides or car accidents. Preliminary data suggest that number grew to nearly 60,000 in 2016. In one Ohio county, deaths from drug overdoses – the bulk of which were caused by powerful synthetic opioids like fentanyl – surpassed deaths from homicides, suicides and car crashes combined.

And 2017 is expected to be even worse.

Read the full study below:

2017.08.08ajpmopiates by zerohedge on Scribd

"It's Raining Needles" Locals Frustrated As Opioid Addicts Litter Ground With Syringes

Drug-overdose deaths rose 19% in 2016 to 52,000, making drugs the leading killer of American adults under 50. And all evidence suggests these totals have continued to climb in 2017, propelled by the worsening opioid epidemic or the fact that more dangerous opioid analogues like fentanyl and carfentanil are findng their way into the drug supply.

Indeed, the US has a higher rate of drug related deaths than any other developed country in the world. As we’ve reported previously, the epidemic is straining public resources like hospitals, local police departments, and child services which in many states have seen a surge in cases where the parents are addicted to opioids. To that list, we can now add local public health department in areas hit hard by the epidemic, which are struggling to clean up a flood of used and possibly infected needles discarded by addicts. 

“They hide in weeds along hiking trails and in playground grass. They wash into rivers and float downstream to land on beaches. They pepper baseball dugouts, sidewalks and streets. Syringes left by drug users amid the heroin crisis are turning up everywhere.

In Portland, Maine, officials have collected more than 700 needles so far this year, putting them on track to handily exceed the nearly 900 gathered in all of 2016. In March alone, San Francisco collected more than 13,000 syringes, compared with only about 2,900 the same month in 2016.”

People, often children, risk getting stuck by discarded needles, raising the prospect they could contract blood-borne diseases such as hepatitis or HIV or be exposed to remnants of heroin or other drugs. It"s unclear whether anyone has gotten sick, but the reports of children finding the needles can be sickening in their own right. One 6-year-old girl in California mistook a discarded syringe for a thermometer and put it in her mouth; she was unharmed, according to NBC Boston.

“‘I just want more awareness that this is happening,’ said Nancy Holmes, whose 11-year-old daughter stepped on a needle in Santa Cruz, California, while swimming. ‘You would hear stories about finding needles at the beach or being poked at the beach. But you think that it wouldn"t happen to you. Sure enough.’

They are a growing problem in New Hampshire and Massachusetts — two states that have seen many overdose deaths in recent years.

‘We would certainly characterize this as a health hazard,’ said Tim Soucy, health director in Manchester, New Hampshire"s largest city, which collected 570 needles in 2016, the first year it began tracking the problem. It has found 247 needles so far this year.”

Needles turn up in places like parks, baseball diamonds, trails and beaches, places where drug users can gather and attract little attention. They toss the needles out of carelessness, or the fear of being prosecuted for possessing them.  One child was poked by a needle left on the grounds of a Utah elementary school. Another youngster stepped on one while playing on a beach in New Hampshire. Even if these children did"t get sick, they still had to endure a battery of tests to make sure they didn"t catch anything. The girl who put a syringe in her mouth was not poked but had to be tested for hepatitis B and C, her mother said.

Some community advocates have started helping out, organizing patrols to dispose of illegally discarded needles. 

"Rocky Morrison leads a cleanup effort along the Merrimack River, which winds through the old milling city of Lowell, and has recovered hundreds of needles in abandoned homeless camps that dot the banks, as well as in piles of debris that collect in floating booms he recently started setting.

He has a collection of several hundred needles in a fishbowl, a prop he uses to illustrate that the problem is real and that towns must do more to combat it.

"We started seeing it last year here and there. But now, it"s just raining needles everywhere we go," said Morrison, a burly, tattooed construction worker whose Clean River Project has six boats working parts of the 117-mile (188-kilometer) river."

Still, children continue to find, and sometimes accidentally stick themselves with, the discarded needles – it’s another way in which the worsening public-health crisis that is the opioid epidemic disproportionately impacts the young. Some parents in Santa Cruz, Calif. even talk about the first time children find a needle as a rite of passage.

Among the oldest tracking programs is in Santa Cruz, California, where the community group Take Back Santa Cruz has reported finding more than 14,500 needles in the county over the past 4 1/2 years. It says it has gotten reports of 12 people getting stuck, half of them children.

"It"s become pretty commonplace to find them. We call it a rite of passage for a child to find their first needle," said Gabrielle Korte, a member of the group"s needle team. "It"s very depressing. It"s infuriating. It"s just gross."

Along the Merrimack, nearly three dozen riverfront towns are debating how to stem the flow of needles. Two regional planning commissions are drafting a request for proposals for a cleanup plan. They hope to have it ready by the end of July.

"We are all trying to get a grip on the problem," said Haverhill Mayor James Fiorentini. "The stuff comes from somewhere. If we can work together to stop it at the source, I am all for it."

While the crisis’s epicenter is in Ohio and the Rust - opioid-related deaths in Ohio jumped from 296 in 2003 to 2,590 in 2015 - Northeastern states like Massachusetts, New Jersey and even Vermont and New Hampshire have been especially hard hit.

In Ohio, resources have been spread so thin that one city council member has proposed a controversial solution: When people who dial 911 seeking help for someone who"s overdosing on opioids, they may start hearing something new from dispatchers: “No.” Dan Picard, a city councilman in Middletown, Ohio, population 50,000, floated the idea.

Picard and others have described his proposal as a cry of frustration.

“It’s not a proposal to solve the drug problem,” Picard said this week. “My proposal is in regard to the financial survivability of our city. If we’re spending $2 million this year and $4 million next year and $6 million after that, we’re in trouble. We’re going to have to start laying off. We"re going to have to raise taxes,” he told the Washington Post.

But as death tolls rise, and local morgues run out of room for more bodies, Picard"s proposal begs the question: What, exactly is our plan for dealing with this crisis?

The Real Cause Of The Opioid Epidemic: Scarcity Of Jobs And Positive Social Roles

Authored by Charles Hugh Smith via OfTwoMinds blog,

The employment rate for males ages 25-54 has been stairstepping down for 30 years, but it literally fell off a cliff in 2009.

We all know there is a scourge of addiction and premature death plaguing the nation, a scourge that is killing thousands and ruining millions of lives: the deaths resulting from the opioid epidemic (largely the result of "legal" synthetic narcotics) are mounting at an alarming rate:

We also know that the proximate cause of this epidemic is Big Pharma, which promised non-addictive painkillers that lasted for 12 hours but delivered addictive painkillers that did not last 12 hours.

The unsavory truth was reported by the Los Angeles Times last May (2016) in a scathing investigative series: "You Want a Description of Hell?" Oxycontin"s 12-hour problem.

There are plenty of other participants who share responsibility for the public health and law-enforcement disaster: physicians who all too readily passed out prescriptions for powerful synthetic opioids like aspirin; the government agencies that approved the synthetic heroin as "safe" (heh) and paid for their distribution via Medicaid, the Veterans Administration, etc., and the patients who all too willingly accepted the false promises of synthetic opioids.

But what"s missing from the public conversation is the underlying cause of the epidemic: a structural scarcity of paid work and positive social roles for vast swaths of America"s workforce.

We all know what paid work means: jobs. Positive social roles include jobs--supporting oneself and one"s family provides purpose, meaning, identity and a source of pride, all atrributes of positive social roles--but the concept extends beyond work to any role in which the participant feels needed and that offers dignity: this includes volunteer, guardian, mentor, coach, etc., many of which are unpaid.

A significant essay in the March/April issue of Foreign Affairs describes The Dignity Deficit: Reclaiming Americans" Sense of Purpose (subscription or registration required)

At its core, to be treated with dignity means being considered worthy of respect. Certain situations bring out a clear, conscious sense of our own dignity: when we receive praise or promotions at work, when we see our children succeed, when we see a volunteer effort pay off and change our neighborhood for the better. We feel a sense of dignity when our own lives produce value for ourselves and others. Put simply, to feel dignified, one must be needed by others.

Giving people welfare, cheap prescriptions for opioids and Universal Basic Income (UBI) does not make them feel needed--it makes them feel superfluous and worthless.

The recent decline in male employment in the peak earning years (ages 25-54) is striking: the employment rate for males ages 25-54 has been stairstepping down for 30 years, but it literally fell off a cliff in 2009. Is it coincidental that the opioid epidemic took off around 2010? I don"t think so.

How do you support a consumer economy with stagnant incomes for the bottom 90%, rising basic expenses and crashing employment for males ages 25-54? Answer: you don"t. The males working in two-income families in the top 10% of the work force are doing just fine. It"s the bottom 50% of households that earn a fraction of the top 10% that reflect the decline of paid work for males below the top 20% or so:

The labor force participation rate (percentage of the civilian populace that is in the labor force, i.e. either working or actively seeking employment) has been crashing since 2000.

The participation rate of males has been in structural decine for decades. The entire 30-year boom in employment from 1970 to 2000 bypassed much of the male labor force.

Faced with a scarcity of jobs and social roles that provide the dignity of being needed and productive, people slip into the toxic depths of the opioid epidemic. As I keep saying here, We Need A "Third" Economy, a community economy that provides an abundance of both paid work and positive social roles. I outline such a system in my book A Radically Beneficial World.

Why Middle Class Whites Are Dying Faster (In 6 Painful Charts)

In 2015, a blockbuster study came to a surprising conclusion: Middle-aged white Americans are dying younger for the first time in decades, despite positive life expectancy trends in other wealthy countries and other segments of the US population.

The research, by Princeton University’s Anne Case and Angus Deaton, highlighted the links between economic struggles, suicides, and alcohol and drug overdoses.

Since then, Case and Deaton have been working to more fully explain their findings.

They’ve now come to a compelling conclusion: It’s complicated. There’s no single reason for this disturbing increase in the mortality rate, but a toxic cocktail of factors.

In a new 60-page paper, “Mortality and morbidity in the 21st Century,” out in draft form in the Brookings Papers on Economic Activity Thursday, the researchers weave a narrative of “cumulative disadvantage” over a lifetime for white people ages 45 through 54, particularly those with low levels of education.

Along with worsening job prospects over the past several decades, this group has seen their chances of a stable marriage and family decline, along with their overall health. To manage their despair about the gap between their hopes and what’s come of their lives, they’ve often turned to drugs, alcohol, and suicide.

Meanwhile, gains in fighting heart disease have stalled, and rates of obesity and diabetes have ploddingly climbed.

So the rise in mortality for white mid-life people in America since the late 1990s is actually the final stage of a decades-long process. “It’s about the collapse of white middle class,” said Case. Here are the five big takeaways from the researchers’ new opus.

1) Suicides, alcohol, and drug overdose deaths have gone up across the entire country. (Read: It’s not just a rural problem.)

 Brookings

“Deaths of despair” — or suicide, alcoholism, and drug overdoses, particularly from opioid painkillers — are a growing problem for midlife white people.

As you can see on the left-hand map, the epidemic started in the Southwest. Now it’s “country-wide,” the study authors write, and the increase can be “seen at every level of residential urbanization in the US.” So it’s not just a rural problem or an urban problem — it’s both.

The crisis is particularly acute among middle-aged whites. “The deaths of despair come from a long-standing process of cumulative disadvantage for those with less than a college degree,” Case and Deaton write. “The story is rooted in the labor market, but involves many aspects of life, including health in childhood, marriage, child rearing, and religion.”

 Brookings

In an interview, Deaton explained, “The cohort that entered the labor market in the ’70s on down, their jobs earnings and prospects are worse. That affected their marriage prospects. Marriages got screwed up. They had children out of wedlock. Their pain levels [are] going up.” All that contributes to the deaths of despair.

The study authors don’t see the opioid supply as the fundamental factor here, but “prescription of opioids for chronic pain added fuel to the flames, making the epidemic much worse than it otherwise would have been,” they wrote.

The impact of rising deaths of despair on overall mortality was masked until the late 1990s by the decline of heart disease deaths. But recently that has changed too.

2) Deaths from chronic diseases such as diabetes have been rising

County-level mortality from diabetes, urogenital, blood, and endocrine diseases between 1980 and 2014. You can see these trending up all over the country. JAMA

Progress against mortality from heart disease has slowed and stopped, and deaths from cancer, which had been on a steady decline, are also stagnating in this group.

Meanwhile, other chronic diseases have continued to rise in the whole population, particularly among middle-aged white people. Diabetes’ prevalence has exploded in the US over the past 20 years. Nearly 30 million Americans live with the disease today — more than three times the number in the early 1990s. And this may be a major, underappreciated driver of the mortality trend.

3) The least-educated Americans are suffering the most

 Brookings

The rise in mortality among middle-aged whites is largely being driven by those with a high school degree or less. The researchers find that the gap in mortality between more and less educated is increasing, while mortality is also rising for those without a college degree and falling for those with a college degree.

“It looks like there are two Americas,” Case said. “One for people who went to college and one that didn’t.”

The middle-aged whites with less than a bachelor’s degree saw “progress stop in mortality from heart disease and cancer, and saw increases in chronic lower respiratory disease and deaths from drugs, alcohol, and suicide,” the researchers write.

Why education is such an important health indicator is difficult to untangle, Case added. “But when you think about what happens when industries pull out of towns, the tax base implodes, schools [are] not well funded, and the death spiral continues.”

In the past, people with low levels of education could get a job in a factory and work their way up the chain of command. “You could graduate high school, work at Bethlehem Steel, get more money every year as you get more experienced,” Deaton said, “and turn yourself into one of the famed blue-collar aristocrats of the 1970s.” Now, he added, “There’s a feeling that life has gone, and remainders of that life are getting less and less for each generation.”

To be clear, the study authors don’t buy the idea that one’s income relative to what one expected is influencing mortality. Rather, “It’s the life you expected to have relative to your father or grandfather — it’s just not there anymore,” Deaton said.

4) Other nonwhite racial groups aren’t experiencing the same mortality uptick — so it’s not just about income

 Brookings

As you can see here, mortality for middle-aged black people converged with mortality for middle-aged white people with low levels of education in the late 2000s (though the white population overall is still doing better than African Americans). Meanwhile, mortality rates among Hispanics continued to fall.

These other racial groups aren’t necessarily doing any better economically than their white counterparts, which is part of the reason Case and Deaton don’t accept a simple income explanation for the death uptick.

“It is possible that it is not the last 20 years that matters, but rather that the long-run stagnation in wages and in incomes has bred a sense of hopelessness,” they write. “But ... even if we go back to the late 1960s, the ethnic and racial patterns of median family incomes are similar for whites, blacks, and Hispanics, and so can provide no basis for their sharply different mortality outcomes after 1998.”

Instead, the researchers think the fact that the overall life prospects for white middle-aged people without a BA have declined over time — they are doing worse than their parents on both a personal and professional level, and probably worse than they expected — is nudging mortality downward. This regression is different from the story of progress in the African American community, for example. Here’s Case and Deaton again:

The historian Carol Anderson argued in an interview in Politico (2016) that for whites “if you’ve always been privileged, equality begins to look like oppression,” and contrasts the pessimism among whites with the “sense of hopefulness, that sense of what America could be, that has been driving black folks for centuries.” That hopefulness is consistent with the much lower suicide rates among blacks, but beyond that, while suggestive, it is hard to confront such accounts with the data.

5) This story is unique to the US

 Brookings

The US, particularly middle-aged white Americans, is an outlier in the developed world when it comes to this mid-life mortality uptick.

“Mortality rates in comparable rich countries have continued their pre-millennial fall at the rates that used to characterize the US,” Case and Deaton write. “In contrast to the US, mortality rates in Europe are falling for those with low levels of educational attainment, and are doing so more rapidly than mortality rates for those with higher levels of education.”

If American wants to turn the trend around, then it has to become a little more like other countries with more generous safety nets and more accessible health care, the researchers said. Introducing a single-payer health system, for example, or value-added or goods and services taxes that support a stronger safety net would be top of their policy wish list. (America right now is, of course, moving in the opposite direction under Trump, and shredding the safety net.)

They also admit, though, that it’s taken decades to reverse the mortality progress in America, and it won’t be turned around quickly or easily. But there is one “no-brainer” change that could help, Case added. “The easy thing would be close the tap on prescription opioids for chronic pain.”

Unlike health care and increasing taxes, opioids are actually a public health issue with bipartisan support. Deaton, for his part, was hopeful. Paraphrasing Milton Friedman, he said, “All policy seems impossible until it suddenly becomes inevitable.”