The West Virginia economy is tied for the state economy most damaged by the opioid crisis. Between 1999 and 2015, the volume of prescription opioids per capita in West Virginia rose 1,900 percent, or about 21 percent annually. This dramatic rise in opioid use in West Virginia was associated with a 3.8 percentage point decline in the state’s labor force participation rate of prime-age workers, slowing annual real gross domestic product (GDP) growth by 1.7 percentage points.

Labor Force Participation

Table WV-1 contains the change in the prime-age labor force participation rate due to opioids between 1999 and 2015, and the resulting number of workers absent from the labor force as of 2015.

Table WV-1: Impact of Opioids on Prime-Age Labor Force Participation, 1999-2015

Gender	Prime-Age Labor Force Participation Rate, 1999-2015 (in percentage points)	Workers, 2015 (in thousands)*
Total	-3.8	-25.0
Men	-3.3	-10.7
Women	-4.2	-14.2
*Estimates for each gender may not add to total due to rounding.

The rise in opioid prescriptions from 1999 to 2015 led the labor force participation rate for both prime-age men and women to decline substantially. Opioids lowered the participation rates of prime-age men and women by 3.3 percentage points and 4.2 percentage points, respectively. For perspective, opioids decreased nationwide labor force participation rates of prime-age men and women by 1.4 percentage points and 1.8 percentage points, respectively.

The decline in the prime-age male labor force participation rate in West Virginia means that in 2015 10,700 men were absent from the labor force due to opioids. The steeper decline in prime-age female labor force participation means that even more women were absent from the labor force. In 2015, opioids kept 14,200 women in West Virginia out of the labor force. Together, the growth in per capita prescription opioids from 1999 to 2015 caused the total prime-age labor force participation rate in West Virginia to decline by 3.8 percentage points. That translates to a loss of 25,000 workers as of 2015.

Work Hours

From 1999 to 2015, the rise in opioid dependency and resulting decline in prime-age labor force participation cumulatively cost West Virginia’s economy 360 million work hours. Table WV-2 contains the cumulative loss of work hours associated with West Virginia’s decline in labor force participation.

Table WV-2: Impact of Opioids on Work Hours, 1999-2015

Gender	Work Hours, Cumulative 1999-2015 (in millions)
Total	-360
Men	-155
Women	-205

As the number of individuals absent from the labor force due to opioids grew, West Virginia’s economy lost an increasing number of work hours. Between 1999 and 2015, West Virginia cumulatively lost a total of 360 million work hours. Since opioid dependency led more women out of the labor force than men, the majority—57 percent—of the lost work hours was attributed to West Virginia’s decline in female labor force participation. Specifically, the state’s economy lost 205 million work hours due to absent female workers, and lost 155 million work hours due to absent male workers.

Real Economic Growth

The hundreds of millions of lost work hours was a major drag on West Virginia’s economic growth. Table WV-3 contains the cumulative reduction in real economic output due to the opioid crisis and the associated decline in the annual real GDP growth rate.

Table WV-3: Impact of Opioids on Real Economic Growth, 1999-2015 (in 2009 dollars)

Gender	Real Output, Cumulative 1999-2015 (in billions)*	Annual Real GDP Growth Rate, 1999-2015 (in percentage points)*
Total	-$21.0	-1.7
Men	-$9.0	-0.8
Women	-$11.9	-1.0
*Estimates for each gender may not add to total due to rounding.

From 1999 to 2015, the opioid-induced decline in West Virginia’s labor force participation was a major cost to the state’s economy. From 1999 to 2015, West Virginia’s economy cumulatively lost $21.0 billion in real economic output, which translates to the state’s annual real GDP growth rate slowing by 1.7 percentage points. To put this loss in perspective, from 1999 to 2015, West Virginia’s real GDP grew 0.8 percent annually. Had opioids not drawn 25,000 prime-age workers out of the labor force, the state’s economic growth rate would have more than tripled.

Since more women left the labor force due to opioids than men, the decline in female labor force participation resulted in a larger portion of the economic cost. The decline in female labor translated to a cumulative loss of $11.9 billion in real output between 1999 and 2015, slowing West Virginia’s real GDP growth rate by 1.0 percentage point. The decline in male workers cost the economy $9.0 billion, which reduced the state’s real GDP growth rate by 0.8 percentage points.