Visualizing opioid misuse and labor market tightness over time.

• Author: Brewer, Ryan M.

Like other states in America, Indiana currently finds itself in the midst of a severe public health crisis-the opioid misuse epidemic. This epidemic is, of course, the cause of immeasurable heartache, loss and suffering on a scope difficult for any words to effectively capture. To assist leaders and stakeholders in Indiana with identification and ultimately implementation of solutions capable of eliminating the epidemic, we feel it is important as an initial step in the process to quantify economic damages. Doing so can provide measurement context-so we can better understand the magnitude of the effects of the crisis on our economy and our growth potential.

Furthermore, quantifying economic damages will allow government, business and other thought leaders to better assess how important the epidemic is from an investment-in-solutions perspective.

This article presents a visualization of the crisis in a way that captures a core component of total economic damages: losses to gross state product (GSP). In this context, counties experiencing tighter labor markets can less afford to lose laborers to the opioid crisis, as positions are already difficult to fill. Mapping this problem across the state's 92 counties over time gives readers quick, intuitive insight as to where the problem is hitting our state hardest, which allows leaders of those communities to redouble their focus as we attempt to develop solutions to the evolving, costly epidemic.

In a separate article in this issue, the authors estimated that the cumulative cost of the opioid epidemic to the state of Indiana through December 31, 2017, totaled $43.3 billion. (1) Moreover, the ongoing annual costs have been accelerating, with 2017 damages totaling approximately $4.3 billion. We expect economic damages from opioids misuse in 2018 in Indiana to again exceed $4 billion.

These initial state-level numbers are helpful in highlighting the costs to us as a statewide community. However, opioid misuse costs are not materializing equally across the local areas wherein each of us commonly work, socialize, raise children and recreate. Differences in costs at the local level surface from differences in misuse rates, emergency response consumption rates and overdose death rates-which all vary by local community. Further, it has been established that the current crisis harms geographic locations experiencing high levels of labor market tightness. (2)

Labor markets

As we discuss the intersection of labor market slack and opioid misuse, it should be noted that we neither argue that opioid misuse causes labor market slack, nor that labor market slack causes opioid misuse. Rather, we are presenting these conditions together, as they are, without...