The Rise of Prescription Opioids and Enrollment in Disability Insurance

David M. Cutler, Ellen R. Meara, Susan Stewart

NBER Disability Research Center Paper No. NB 16-03
Issued in September 2016

Working age individuals frequently suffer chronic pain, making musculoskeletal impairments the most common reason for new disability insurance awards in the last decade. Little research has asked whether and how medical treatment for such patients might influence entry onto disability insurance, nor do we know whether and how medical advances prevent labor market exit among those suffering from chronic pain. In this preliminary work, we isolated cohorts of adults age 50 to 55 with back pain and followed their labor market participation and disability enrollment over eight years. Over one third of adults in this age group report suffering from back pain. During our period of study, 1996 through 2014, the prescription of opioids to treat chronic pain more than doubled. We examined whether later cohorts of adults with back pain, those exposed to higher volume opioid prescribing for chronic pain, were any less likely to transition to disability insurance, or exit labor market compared with earlier cohorts, unlikely to be treated for pain with opioids. Comparing cohorts of adults with back pain across years, however, the trend towards disability insurance was remarkably similar. In each cohort, individuals increased their enrollment in DI steadily over time. By 8 years from baseline, across all cohorts, 7-10 percent of older adults with back pain had enrolled in DI. A similar stability over time occurred when we examined labor force participation among adults with back pain.

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