“…There is evidence that OUDs increase the health care needs of individuals and their family members (Reinhart et al 2018), reduce labor force participation rates (Aliprantis, Fee, and Schweitzer 2019; Deiana and Giua 2018; Harris et al 2020; Park and Powell 2021), negatively affect the ability to meet family needs such as the care of children (Buckles, Evans, and Lieber 2020; Evans, Lieber, and Power 2019; Gihleb, Giuntella, and Zhang 2019), and increase involvement in criminal activity (Bondurant, Lindo, and Swensen 2018; Dave, Deza, and Horn 2018; Wen, Hockenberry, and Cummings 2017). If these effects on individuals are widespread enough, they may significantly affect the need for state and local government expenditures on Medicaid and health services, income maintenance programs, child protection services, and police and criminal justice services.…”