The opioid crisis has reshaped American life in ways that are clearly visible. Abby Alpert’s new research examines how those effects extend into the workplace, where the consequences are sometimes less immediately seen.
Alpert, a Dorinda and Mark Winkelman Distinguished Faculty Scholar and associate professor of health-care management at Wharton, is co-author of a new study that investigates how opioid use affects workplace performance and career trajectories. She co-wrote the paper with the University of Texas at San Antonio’s Stephen Schwab GRW18 and Texas A&M University’s Benjamin Ukert, a former Wharton and Perelman School of Medicine postdoctoral fellow.
Much of the existing research, Alpert says, has focused on “the consequences for overdose mortality and the health consequences of this crisis.” While previous work has also documented links between opioids and broader labor outcomes, far less is known about how a prescription can ripple through an individual’s job performance, advancement prospects, and continued employment over time.
To answer that question, the researchers turned to the U.S. military, where anonymized medical and personnel data can be linked in ways rarely possible elsewhere. By connecting those two sources, the researchers could observe not only who received an opioid prescription, but also who was promoted, disciplined, tested for fitness, or separated from service. “That type of data,” Alpert says, “is not typically available for employers.”
The results are clear. Within a year of subjects first receiving an opioid prescription, the likelihood of a promotion declined by five percent. Probabilities of disciplinary action for behavioral infractions such as tardiness and discipline-related job separations rose by 12 percent and 26 percent, respectively. “It’s the behavioral consequences of opioid abuse that are easiest for employers to detect,” says Alpert. Because many opioid-positive drug tests are accompanied by legal prescriptions, employers rarely discipline drug use itself. Instead, the effects show up indirectly in behaviors where supervisors have clearer authority to act.
The findings suggest that the effects of the opioid epidemic are often difficult to pinpoint in the workforce. While the military provides unusually rich data, there is little reason to think the mechanisms are unique to service members. “I believe this is also more generalizable,” says Alpert, “and that you would probably see similar productivity losses in civilian jobs.”
Published as “At the Whiteboard With Abby Alpert” in the Spring/Summer 2026 issue of Wharton Magazine.
