The opioid epidemic isn’t just affecting individuals and families—it’s also affecting the U.S. workforce. 

According to a recent study by the American Action Forum, nearly 1 million people were not working in 2015 due to opioid use. 

More specifically, the study states that in 2015, 919,400 people ages 25 to 54 were not at work because of their opioid dependence. That number grew every year between 1999 and 2015.

Over that 16-year span, the study found that the lack of employees cost the U.S. economy about $44 billion per year, for a total of about $702 billion. “It’s a pretty big drag on the U.S. economy,” Ben Gitis, who co-authored the study with intern Isabel Soto, told the Washington Post. 

The study found that over the 16 years, the economic growth rate actually slowed by 0.2 percentage points. 

Gitis tells the Post, “Estimates suggest, had these workers been in the labor force and not addicted to opioids, the growth rate would have been 2.2%.”

The research conducted in Gitis’s study built off prior research by economist Alan Krueger of Princeton University. In 2017, Krueger published a paper that estimated that the painkiller prescription increase may have factored into “20% of the observed decline in workforce participation among men and 25% among women.”

In his study, Krueger acknowledged that areas in the U.S. with the highest amount of opioid prescriptions aligned with large drop-offs of those in the workforce. 

Combining Krueger’s ideas and national data over a 16-year span, Gitis was able to estimate the number of people kept out of the workforce because of opioid use. Gitis found that men and women were affected differently, the Post reports. For women, 6.4 billion hours of work were lost over that time frame, whereas men lost 5.7 billion hours. 

In some areas, employers looking to fill job vacancies say one issue they face is that potential applicants cannot pass drug screenings. 

“It’s something we hear companies talk about all the time, not being able to have workers pass drug tests and being unable to simply get workers to apply because they know they won’t pass the drug test,” Gitis told the Post. “It was really important that we get a sense of what the magnitude of this could be.” 

While opioid use is a prominent health issue in the country, Gitis tells the Post it’s also important to acknowledge its impact on the economy. 

“Of course the opioid crisis is a major health issue,” he said. “The overdose fatalities by themselves suggest how big of a problem it is. But it’s also a major constraint on our economy.”