The misuse of prescription painkillers, heroin and synthetic opioids like fentanyl is, by now, painfully well known. The U.S. tops the world in drug deaths; in 2015, more people died from overdoses — with two thirds involving an opioid — than from car accidents or gun violence.

The epidemic is also having a devastating effect on companies — large and small — and their ability to stay competitive. Managers and owners across the country are at a loss in how to deal with addicted workers and potential workers, calling the issue one of the biggest problems they face. Applicants are increasingly unwilling or unable to pass drug tests; then there are those who pass only to show signs of addiction once employed. Even more confounding: how to respond to employees who have a legitimate prescription for opioids but whose performance slips. “That is really the battlefield for us right now,” said Markus Dietrich, global manager of employee assistance and worklife services at chemical giant DuPont, which employs 46,000 worldwide.

The issue is amplifying labor shortages in industries like trucking, which has had difficulty for the last six years finding qualified workers. It’s also pushing employers to broaden their job searches, recruiting people from greater distances when roles can’t be filled with local workers. At stake is not only safety and productivity within companies — but the need for humans altogether, with some manufacturers claiming opioids force them to automate work faster.

The opioid crisis is creating a fresh hell for America’s employers

YOUNGSTOWN, Ohio — Just a few miles from where President Trump will address his blue-collar base here Tuesday night, exactly the kind of middle-class factory jobs he has vowed to bring back from overseas are going begging.

It’s not that local workers lack the skills for these positions, many of which do not even require a high school diploma but pay $15 to $25 an hour and offer full benefits. Rather, the problem is that too many applicants — nearly half, in some cases — fail a drug test.

The fallout is not limited to the workers or their immediate families. Each quarter, Columbiana Boiler, a local company, forgoes roughly $200,000 worth of orders for its galvanized containers and kettles because of the manpower shortage, it says, with foreign rivals picking up the slack.

“Our main competitor in Germany can get things done more quickly because they have a better labor pool,” said Michael J. Sherwin, chief executive of the 123-year-old manufacturer. “We are always looking for people and have standard ads at all times, but at least 25 percent fail the drug tests.”

The economic impact of drug use on the work force is being felt across the country, and perhaps nowhere more than in this region, which is struggling to overcome decades of deindustrialization.

Economy Needs Workers, but Drug Tests Take a Toll

[W]hen it’s suggested that our current set of arrangements won’t last forever people immediately imagine Mad Max, as if no other alternative exists. Things are going to change. They always have and they always will. The future will just be different. That’s absolutely not the same as saying the world is coming to an end. Clear eyed individuals who are paying attention can start to get a feel for who the new winners and losers are likely to be and place themselves in the best possible situation ahead of the curve. That’s a pragmatist’s view – not a doomer’s.

. . .

If small scale agriculture was made redundant by mechanization and industrial scale production, then industry itself was hammered by other equally powerful forces. Everything has a beginning, middle, and end.

. . .

The most recent iteration of the Zombie Apocalypse has already begun to unfold in some places. Suburbia was exactly the right thing for a particular period of time. But that era is winding down. The modest tract homes and strip malls built after World War II are not holding up well in an increasing number of marginal landscapes. I have been accused of cherry picking my photo ops, particularly by people who engage in their own cherry picking when discussing the enduring value of prosperous suburbs. But there’s too much decay in far too many places to ignore the larger trend. The best pockets of suburbia will carry on just fine. But the majority of fair-to-middling stuff on the periphery is going down hard.

. . .

The future drivers of change will be the same as the previous century – only in reverse. The great industrial cities of the early twentieth century as well as the massive suburban megaplexes that came after them were only possible because of an underlaying high tide of cheap abundant resources, easy financing, complex national infrastructure, and highly organized and cohesive organizational structures. Those are the elements of expansion.

But once the peak has been reached there’s a relentless contraction. The marginal return on investment goes negative as the cost of maintaining all the aging structures and wildly inefficient attenuated systems becomes overwhelming. The places that do best in a prolonged retreat from complexity are the ones with the greatest underlying local resource base and most cohesive social structures relative to their populations. The most complex places with the most critical dependencies will fail first as the tide recedes.

. . .

Over the long haul Main Street has a pretty good chance of coming back along with the family farm. But the shorter term in-between period of adjustment to contraction is going to be rough as existing institutions attempt to maintain themselves at all costs.

Postcards From the Zombie Apocalypse

A slew of reports finds a fresh reason for the chronic inability of American companies to fill skilled jobs: not a lack of skills, and hence a training-and-education crisis, but a surfeit of drug abuse, per the NYT’s Nelson Schwartz. Simply put, prime-working age Americans without a college diploma are often too drugged-out to get the best jobs. Opioids remain at high levels, but the surge in drug use is now heroin and the powerful contaminant fentanyl.

The reports suggest a circularity to the crisis in America’s rust and manufacturing belts: the loss of jobs and wage stagnation has led to widespread disaffection, alienation and drug abuse; and drug abuse has led to joblessness, hopelessness and disaffection.

But the numbers are all over the map. Some employers and economists say up to half of job applicants do not clear drug tests; others say it is 25%. In the chart above, Indeed economist Jed Kolko, using data from the U.S. Current Population Survey, found that 5.6% to 5.7% of working-age adults didn’t work last year because of illness or disability, an unknown percentage of which were because of drug use.

Many Americans are too drugged-out to work

“Temperance” commonly is understood in a narrow sense as referring only to abstention from alcohol. But it has a classical meaning that takes in far more.

Aristotle understood that. “The temperate man desires the right things in the right way and at the right time,” he wrote. That may indeed involve swearing off some good thing, either temporarily or permanently, but more often it will mean using good things, but in a way that’s reasonable and suited to their purposes.

At first one might think this was so obvious that it hardly needs stating. But apparently that isn’t so for large sectors of American society today. Granted the exceptions, ours on the whole is a very wealthy country where pampered self-indulgence is not only accepted but held up as an ideal.

Doubt that? Then spend a little time watching TV commercials, with their unabashed appeals to easy, instantaneous gratification, whether by drinking beer or driving a luxury automobile. Pope St. John Paul II called this state of mind and soul “superdevelopment” and said that in its own way it was “as harmful as excessive poverty.” Whatever you call it, it’s the mortal foe of temperance.

Intemperance is typical of children and of adults with childish temperaments. That suggests that acquiring temperance is a matter of formation, a part of growing up. And that means temperance and the behaviors associated with it can and should be taught. Teaching temperance is a central task of formation agents who include parents, churches, schools, and the media.

And there’s the rub. There is money—big money—to be made by exploiting intemperance, and the formation agents of American popular culture seem bent on making it. Find a way to change that, and we will have taken a giant step toward solving the national crisis of addiction.

America’s opioid crisis says a lot about how we are forming our people

There have always been drug addicts in need of help, but the scale of the present wave of heroin and opioid abuse is unprecedented. Fifty-two thousand Americans died of overdoses in 2015—about four times as many as died from gun homicides and half again as many as died in car accidents. Pawtucket [Rhode Island] is a small place, and yet 5,400 addicts are members at Anchor (Recovery Community Center). Six hundred visit every day. Rhode Island is a small place, too. It has just over a million people. One Brown University epidemiologist estimates that 20,000 of them are opioid addicts—2 percent of the population.

. . .

At the turn of the nineteenth century, scientists isolated morphine, the active ingredient in opium, and in the 1850s the hypodermic needle was invented. They seemed a godsend in Civil War field hospitals, but many soldiers came home addicted. Zealous doctors prescribed opiates to upper-middle-class women for everything from menstrual cramps to “hysteria.” The “acetylization” of morphine led to the development of heroin. Bayer began marketing it as a cough suppressant in 1898, which made matters worse. The tally of wrecked middle-class families and lives was already high by the time Congress passed the Harrison Narcotics Tax Act in 1914, threatening jail for doctors who prescribed opiates to addicts. Americans had had it with heroin. It took almost a century before drug companies could talk them back into using drugs like it.

If you take too much heroin, your breathing slows until you die. Unfortunately, the drug sets an addictive trap that is sinister and subtle. It provides a euphoria—a feeling of contentment, simplification, and release—which users swear has no equal. Users quickly develop a tolerance, requiring higher and higher amounts to get the same effect. The dosage required to attain the feeling the user originally experienced rises until it is higher than the dosage that will kill him. An addict can get more or less “straight,” but approaching the euphoria he longs for requires walking up to the gates of death. If a heroin addict sees on the news that a user or two has died from an overly strong batch of heroin in some housing project somewhere, his first thought is, “Where is that? That’s the stuff I want.”

. . .

Difficult though recovery from addiction has always been, it has always had this on its side: It is a rigorously truth-focused and euphemism-free endeavor, something increasingly rare in our era of weasel words. The face of addiction a generation ago was that of the working-class or upper-middle-class man, probably long and intimately known to his neighbors, who stood up at an AA meeting in a church basement and bluntly said, “Hi, I’m X, and I’m an alcoholic.”

The culture of addiction treatment that prevails today is losing touch with such candor. It is marked by an extraordinary level of political correctness. Several of the addiction professionals interviewed for this article sent lists of the proper terminology to use when writing about opioid addiction, and instructions on how to write about it in a caring way. These people are mostly generous, hard-working, and devoted. But their codes are neither scientific nor explanatory; they are political.

. . .

Addiction plays on our strengths, not just our failings. It simplifies things. It relieves us of certain responsibilities. It gives life a meaning. It is a “perversely clever copy of that transcendent peace of God.”

The founders of Alcoholics Anonymous thought there was something satanic about addiction. The mightiest sentence in the book of Alcoholics Anonymous is this: “Remember that we deal with alcohol—cunning, baffling, powerful!” The addict is, in his own, life-damaged way, rational. He’s too rational. He is a dedicated person—an oblate of sorts, as Seeburger puts it. He has commitments in another, nether world.

American Carnage, by Christopher Caldwell