Loss of Life and Labor Productivity: The Canadian Opioid Crisis

AuthorAlexander Cheung,Joseph Marchand,Patricia Mark
DOIhttp://doi.org/10.1177/00027162231155040
Published date01 September 2022
Date01 September 2022
ANNALS, AAPSS, 703, September 2022 303
DOI: 10.1177/00027162231155040
Loss of Life and
Labor
Productivity:
The Canadian
Opioid Crisis
By
ALEXANDER CHEUNG,
JOSEPH MARCHAND,
and
PATRICIA MARK
1155040ANN THE ANNALS OF THE AMERICAN ACADEMYLOSS OF LIFE AND LABOR PRODUCTIVITY
research-article2023
Opioids were declared a public health emergency in
British Columbia, Canada, in 2016, and from that year
through 2021, 29,894 Canadians lost their lives to opi-
oid overdoses. More than two-thirds of those victims
were employed in the five years prior to their deaths,
and this study aims to quantify their lost productivity to
the Canadian economy. We apply two human capital
model variants in our analysis, projecting forward the
future economic output of individuals who died from
opioids, from their deaths to what would have been
their eventual retirements, based on the industries in
which they were employed. The total estimated pro-
ductivity loss to Canada is at least $8.8 billion, with the
equivalent “value of statistical life” calculations an
order of magnitude higher; these are based on esti-
mates of the amount of money that individuals would
pay to avoid death. Our results challenge the notion
that the opioid crisis predominantly affects unproduc-
tive members of society.
Keywords: British Columbia; Canada; human capital;
labor productivity; opioids; public health
emergency; value of statistical life
The opioid crisis is present in countries
across the globe, but the magnitude of its
effects is highest in North America. Canada has
closely paralleled the U.S. in both the timing
and the severity of its opioid crisis. While
Massachusetts was the first U.S. state to declare
opioids an emergency to public health on
March 27, 2014, British Columbia was the first
Correspondence: joseph.marchand@ualberta.ca
Alexander Cheung is a master of economics student
at the University of Alberta in Edmonton, Alberta,
Canada. Prior to his graduate studies, he was an
undergraduate student in economics and a recipient of
a Roger S. Smith Undergraduate Researcher Award at
the University of Alberta.
Joseph Marchand is a professor in the Department of
Economics at the University of Alberta in Edmonton,
Alberta, Canada. He is a labor economist who served as
the chair of the Minimum Wage Expert Panel for the
Government of Alberta and as an expert witness for the
Senate of Canada.
304 THE ANNALS OF THE AMERICAN ACADEMY
Canadian province to do so only two years later, on April 14, 2016. However, the
U.S. declared a nationwide public health emergency just a year and a half after
that, on October 26, 2017, and Canada has yet to reciprocate, but such an
announcement seems almost inevitable.
The U.S. and Canada have the first and second highest number of per capita
opioid users globally (Belzak and Halverson 2018). Historically, up to one in five
Canadians were using a medical-grade opioid by 2010 (Fischer, Pang, and
Tyndall 2019). Similarly, one in four Americans were prescribed an opioid medi-
cation annually, and 259 million opioid prescriptions had already been dispensed
by 2012. Even worse, the U.S. and Canada held the dubious distinction of having
had the first and second highest opioid-related deaths per million inhabitants
across twenty-five countries from 2011 to 2016 (Organisation for Economic
Co-operation and Development [OECD] 2019). And unfortunately, this issue
has not abated, with both the U.S. and Canada still having the highest amounts
of drug overdose deaths in the early 2020s, even in conjunction with the COVID-
19 pandemic and its death toll.
The opioid crisis has been so severe in magnitude in North America that it
caused overall declines in life expectancy and increases in overall mortality rates.
Illicit drug deaths are now the number one cause of unnatural deaths in both
Canada and the U.S. More generally, the “deaths of despair” from alcohol, opi-
oids, and suicide have been linked to an alarming and dramatic increase in the
mortality rate between 1999 and 2013 in the U.S., which was especially pro-
nounced among White non-Hispanic Americans (Case and Deaton 2015). This
trend for the U.S. showed a progression when updated to 2015; and while
Canada’s mortality rate was lower, the rate of its decrease was trending down-
ward, which raised a warning flag (Case and Deaton 2017).
One way to quantify the magnitude of such a loss of life is through the labor
market, which has already been previously linked to opioids in several U.S. stud-
ies (one of the four main conclusions of the review by Maclean et al. 2021). For
example, local increases in per capita opioid prescriptions have been subse-
quently associated with reduced labor force participation rates (Aliprantis, Fee,
and Schweitzer 2019; Krueger 2017; Harris et al. 2019; Powell 2021), and opioids
have had a small positive effect on the employment-to-population ratio for
women but not for men (Currie, Jin, and Schnell 2019). Looking the other way
around, a one percent increase in the local county unemployment rate was associ-
ated with a three-and-a-half percent increase in the opioid death rate
(Hollingsworth, Ruhm, and Simon 2017). And, opioid overdose deaths signifi-
cantly increased in U.S. counties within five years of having an automotive plant
closure (Venkataramani et al. 2020).
In the current study, the labor market is used to quantify the impact the opioid
crisis has had in Canada through several calculations of lost labor productivity
among its opioid overdose victims. Two variants of the human capital (HC)
Patricia Mark was an addictions medicine physician with the Vancouver Island Health
Authority in British Columbia, Canada. She was a pioneer of methadone treatment on Central
Vancouver Island in the 1990s and spent her career working with marginalized and unhoused
populations. She passed away on April 8, 2021.

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