The Causes and Consequences of Opioid Use among Older Americans: A Panel Survey Approach

Authors

Abstract

This study examines the effects of prescription opioid analgesic use for older Americans, specifically with regard to work disability and disability program participation. We draw on the long-panel structure of the Health and Retirement Study and a newly available 2009 survey module measuring prescription drug use and initiation. We pursue regression-adjustment and nearest neighbor matching approaches, using rich 2008 HRS measures on health, disability, sociodemographic characteristics, and economic status, to account for selection into prescription opioid use, since supply-side instruments used in the opioid literature have little relevance to opioid use for this population in 2009. Pre-2008 comparisons between individuals with 2009 opioid prescriptions and controls demonstrate face validity of the analytic approach; we then estimate opioid use effects on mortality, self-reported health, labor force participation, work-limiting health conditions, and disability program participation, spanning from 2010 to 2018. We find substantial and significant mortality effects starting in 2010; in estimating effects on other outcomes, we account for differential attrition through mortality via inverse probability reweighting. Our findings are significant, both statistically and economically: up through 2018, individuals with 2009 opioid prescriptions were nearly 40% more likely to develop a health condition that limited their ability to work than those without a prescription. This difference in work disability led to substantial differences in disability program participation: those using opioids were nearly 300% more likely to apply for or receive Social Security disability benefits by 2018.

Key Findings

  • We estimate the impact of 2009 opioid prescription drug use on mortality, health, labor force status, work disability, and disability program participation using the Health and Retirement Study.
  • Long-panel structure allows for rich pre-drug-initiation controls and nearly a decade of observation of differences after 2009 prescription opioid use among older workers.
  • Older workers with 2009 opioid prescriptions were 15 percentage points (40% over non-user baseline) more likely to develop a work-limiting health condition through 2018.
  • Older workers with 2009 opioid prescriptions were 30 percentage points (300% over non-user baseline) more likely to apply for or receive Social Security disability benefits in 2016 and 2018.

Citation

Armour, Philip, Rosanna Smart, and Elliott Brennan. 2021. “The Causes and Consequences of Opioid Use Among Older Americans: A Panel Survey Approach.” Ann Arbor, MI. University of Michigan Retirement and Disability Research Center (MRDRC) Working Paper; MRDRC WP 2021-419. https://mrdrc.isr.umich.edu/publications/papers/pdf/wp419.pdf

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Project

Paper ID

WP 2021-419

Publication Year

2021