Loss of Life and Labor Productivity: The Canadian Opioid Crisis

• DOI: http://doi.org/10.1177/00027162231155040
• Published date: 01 September 2022
• Date: 01 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.