Princeton University economist Alan Krueger recently published and presented his paper for Brookings on the opioid crisis and its genesis. Having been declared a national emergency, there are as many economic as well as health issues related to the tragedy. Economists especially those at the Federal Reserve are keen to see this drug abuse as socio-demographic in nature so as to be absolved from failing in their primary task should it be found instead a macro concern. Tortured souls all around.

Dr. Krueger, an economist well-known for his work on minimum wage effects, reports that he had received partial funding for his study from the Federal Reserve Bank of Boston. It shouldn’t really matter but in this case it really seems as if it might.

The paper is itself quite comprehensive and sympathetic. It reports that almost half of men who are of prime working age but not officially part of the labor force take pain medication on a daily basis. This is an outright astonishing finding, though, unfortunately, not at all surprising. The issue of opioid abuse is clearly more than government noise.

But as to causation? In other words, is the opioid epidemic to blame for depressed labor participation, or is it the depressed economy that depresses labor participation leaving far, far too many especially males to seek escape?

Prime age men who are out of the labor force report that they experience notably low levels of emotional well-being throughout their days and that they derive relatively little meaning from their daily activities.

Though it starts out in this fashion, the paper and its 81 pages of text and statistics trends predictably the other way.

Labor force participation has fallen more in areas where relatively more opioid pain medication is prescribed, causing the problem of depressed labor force participation and the opioid crisis to become intertwined.

Dr. Krueger uses something of a statistical jog to make the case that the problem is structural and long predates the monetary events from 2007 forward. Decompressing data by county, he finds that the often vast differences in prescribing tendencies within the medical profession are a prime candidate. Don’t blame the Fed, the doctors have done this.

There is a clear regional pattern to opioid prescription rates and drug overdoses. The average quantity of opioids prescribed per capita varies by a factor of 31 to one in the top 10 percent of counties relative to the bottom ten percent of counties, according to CDC data. Across states, per capita prescription rates vary by a factor of three to one. The CDC argues that, “Health issues that cause people pain do not vary much from place to place, and do not explain this variability in prescribing.”