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Opioids At Work: Hidden Scourge Sapping The Economy

Opioids At Work: Hidden Scourge Sapping The Economy

Authored by James Varney via RealClear Wire,

Strung out on drugs half her life, Brandi…

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Opioids At Work: Hidden Scourge Sapping The Economy

Authored by James Varney via RealClear Wire,

Strung out on drugs half her life, Brandi Edwards, 29, said the longest she held a job before getting sober four years ago was “about two and a half months.”

“I worked at an AT&T call center, a day-care center for a month, fast food places, but I had to take drugs to get out of bed in the morning and when I did show up, I wasn’t productive,” the West Virginia mother of three told RealClearInvestigations. “The first paycheck came along and I was out of there.

Fentanyl. Image 4 of 17. United States Drug Enforcement Administration

In jail for the ninth time on drug-related charges, and separated from her children, Edwards had an awakening in “looking hard at what I’d lost.” Now clean for four years after rehab, she is married and back in her children’s lives with a home in Princeton, W. Va., and a steady job.

But such success stories are too infrequent to offset the massive cost of the opioid epidemic to the American workforce. Only a couple of people in her former addict circle have returned to productive life, she says, while most are dead or incarcerated.

That toll on labor, haunting America’s working present and future probably for years -- if not decades -- to come, is largely invisible and underreported because it is difficult to measure, according to physicians, counselors, economists, workers and public officials. But its staying power is suggested by other lasting national challenges, including the porous southern border -- a major conduit for smuggled, Chinese-made fentanyl -- and economic and social traumas set in motion by the coronavirus pandemic.

In addition to untold years of productivity lost from fatal overdoses, the nation’s labor participation rate has shrunk steadily since 2000. Precise correlation is elusive, but any graph of that decline would stand in sharp contrast to the rise of opioid addiction in the U.S. And while it is difficult to calculate just how much drug use has caused absenteeism, tardiness and stretches of disability, the connection is strong, as Brandi Edwards’ experience suggests.

“We’ve been writing about this for years but it doesn’t seem to get a lot of traction,” said Dr. Gary Franklin, a research professor at the University of Washington who served as the medical director of the state’s Department of Labor and Industries. “People have not realized how much opioids contribute to disability and lost productivity, and I don’t know if anyone has been able to put a number on that.” 

Headline figures on lives lost in the opioid epidemic have been fairly clear for years. In 2021, more than 107,000 people died from drug overdoses, a nearly 15% increase from the year before and more than double the grim tally recorded in 2015, according to the Centers for Disease Control. All told, overdose deaths are seven times higher than they were in 1999.

Synthetic opioids such as fentanyl, which law enforcement has tracked from labs in China along trafficking routes through Mexico on the southern border, are now driving the overdose epidemic. The CDC attributed 69,000 overdose deaths to synthetic opioids in 2020, 82% of the nation's total that year. Heroin overdoses, meanwhile, went up 7% in 2020 to 13,000, according to CDC figures.

That means synthetic opioids and heroin dwarf cocaine and methamphetamines, although totals for both of those have been rising for a decade and often cause overdose deaths in combination with opioids. The National Institutes of Health shows fewer than 5,000 people killed by cocaine alone and fewer than 10,000 by what it dubs "psychostimulants," which includes methamphetamines, in 2020. 

Less precisely, economists since at least 2017 have pegged at over $1 trillion the epidemic’s annual dollar cost in terms of deaths, law enforcement and “lost productivity.” 

But the amount attributable to deaths - $550 billion of the $1 trillion - is largely conjecture because it is derived from actuarial estimates for lost years; for example, the decades cut from what would have been a normal working life for someone who fatally overdoses at age 45.

Then there is the less lethal side of the equation -- one that workers and employers grapple with daily. Roughly 8% of workplace fatalities in 2020 - 388 of 4,786 - were attributed to "unintentional overdose from nonmedical use of drugs," according to the Bureau of Labor Statistics. However, the agency said it is unclear "how many of these deaths involved opioids specifically." 

A post on a neighborhood social media platform asking about opioids’ dire impact in the workforce unleashes a barrage of firsthand horror stories. Homeowners speak of an inability to hire handymen, painters, landscape workers and the like.

If I’m lucky enough to have an employee that can pass a [urine analysis] the chances of them doing so after the first check is slim,” wrote a tree surgeon in suburban New Orleans. “Tree men get a terrible rap. People think we are all crazy, wild, no fear having, hard working dopeheads.”

But he acknowledged some truth to the stories of workplace abuse of prescription opioids, mentioning laborers’ common habit of relying on increasingly higher-milligram dosages of pain pills like Percocet.

Workers “didn’t wake up one day and say, ‘Hmmm, great day to go down a road that will cost me it all,’ " he wrote. "Then it’s inevitable. We get hurt. Usually pretty badly. So we start out getting a few .5 [mg] maybe 7.5. Later, as our careers go so does the pain, so do the amounts needed to consume to keep it at bay.”

A National Safety Council study reported that more than 75% of U.S. employers have been affected by employees’ prescription drug use, according to congressional testimony, and the National Institutes of Health estimates some 3 million Americans, including workers, are addicted to opioids. 

Edwards managed to break her addiction and return to the workforce with the help of Jobs & Hope, a statewide West Virginia placement initiative launched in 2019 that claims more than 1,500 success stories. But with a budget of $3.1 million it cannot handle all of the 200-250 addicts referred to it each month, said Deb Harris, the group’s lead transition agent. 

Businesses have been largely receptive to such programs, but the state is still trying to regain its footing from the “flood of pills” that hit it early in the 21st century, according to Dr. Matthew Christiansen, director of West Virginia’s Office of Drug Control in the Department of Health and Human Services.

“We don’t keep a running tally at the state level, but the numbers have probably stayed pretty consistent or maybe gotten a little bit worse because of an increase in overdose deaths due to fentanyl,” Christiansen said.

The Centers for Disease Control does keep a tally, although it hasn’t publicly updated the grim numbers on its “opioid dashboard” since 2017. The figures from that year show that the biggest economic hit has come in the Appalachian states around the Ohio Valley and in New England, two regions where opioids and synthetics have torn a hole through the workforce.

For example, West Virginia, long considered ground zero in the opioid epidemic, had the biggest annual per capita loss due to opioids at $7,247, according to the CDC figures that include overdose deaths. That tops Ohio, where the per capita cost in 2017 was $6,226, and New Hampshire at $5,953. Ohio saw the highest overall economic cost, at $72.58 billion, followed by Massachusetts at $36.91 billion, according to the CDC. 

Fixing opioid disorder costs is complicated by the fact much of it is now driven by black-market synthetic drugs like fentanyl and thus can no longer be tracked through prescriptions. Nor is substance abuse a topic that workers - or many employers - are comfortable quantifying. All those involved in coping with the epidemic, however, peg the cost as staggering.

“It’s difficult to measure these things but it’s likely a substantial part of the labor decline,” said Michael Betz, an economist at The Ohio State University who researches opioid disorder issues. “You’re piecing together different pieces of evidence, but when you look at the decline in labor participation rates and opioid disorder figures, they match up pretty similarly.”

Franklin’s team did calculate the odds opioids influenced the disability bills Washington state taxpayers foot each year for roughly 100,000 workers, a relatively uncomplicated tally since Washington is one of four states with a centralized government system and not a private workers’ compensation insurance market.

We found that two prescriptions of opioids for more than 7 days in the first six weeks after an injury doubled the risk of a worker being on disability one year later,” he said.

Answers to broader questions on opioids’ baleful economic impact, however, are scarce.

“Productivity losses due to anything is an extremely complex analysis and is not routinely tracked,” Franklin said.

To date, the nation's prime age labor workforce has not recovered to where it was at the beginning of 2020 and is now the lowest it has been in 45 years. The hit has been especially pronounced among older adults, according to the Government Accountability Office.

Between 2015 and 2019, adults 50 years old or older "were an estimated 22 percent less likely to be in the labor force (either employed or actively seeking work),” a GAO report found. In addition, people in that age group "were an estimated 40 percent less likely to be employed; and employed older workers who misused opioids were twice as likely to have experienced periods of unemployment." 

Once again, however, pinpointing the precise connection between opioids and lost productivity remained elusive, as "the data did not allow GAO to determine causality."

Middle-aged white men have long comprised the single biggest group of annual overdose deaths, but between 2015 and 2020 the rate among black men skyrocketed to 54.1 per 100,000, topping white men’s 44.2 per 100,000, according to the Pew Research Center

“Local economic conditions play some part in all this but they aren’t the key role; the main driver is the increase in supply,” Betz said.

That leads some experts on the topic to conclude that opioids’ catastrophic hit to the United States’ workforce has been misconstrued. For a time, as deaths rose early on, particularly among middle-aged white men, and labor participation rates began their decline, the phrase “deaths of despair” took hold among some researchers.

Under this theory, the opioid epidemic fed on declining economic prospects, particularly for middle-aged white men facing unemployment or shrinking incomes.

But the “deaths of despair” theory reverses cause and effect, according to some physicians and people dealing with the fallout from opioids, including their more deadly synthetic cousin fentanyl.

“We’ve debunked that,” said Dr. Andrew Kolodny, a faculty member at Brandeis University whose practice has specialized in opioid addiction. “Rather than economic conditions leading to overdose deaths it’s really the other way around - it’s not the economy driving them to death, it’s the opioid crisis affecting the economy.”

Tyler Durden Fri, 09/30/2022 - 19:00

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Government

Student loan borrowers may finally get answers to loan forgiveness issues

A major student loan service company has been invited to face Congress over its alleged servicing failures.

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U.S. Sen. Elizabeth Warren (D-MA) wants answers from one of the top student loan service companies in the country for allegedly botching its student loan forgiveness process involving the federal Public Service Loan Forgiveness program, leaving borrowers confused and without answers.

The senator sent a letter to Mohela CEO Scott Giles on March 18 inviting him to testify before Congress at a hearing on April 10 titled “MOHELA’s Performance as a Student Loan Servicer.” During the hearing, Giles will have to answer for why his company allegedly failed to send billing statements to student loan borrowers in a timely manner and miscalculated monthly payments for borrowers when it was time for them to repay their loans in September last year.

Related: Here's who qualifies for Biden's student loan debt relief starting next month

Also, in the letter, Warren highlighted a report that claimed that Mohela failed to perform basic servicing functions for borrowers eligible for PSLF, which led to over 800,000 public service workers facing delays in receiving student debt relief. The report also accuses the company of using a “‘call deflection’ scheme” to keep customers away from speaking to a customer service representative and instead redirecting them to parts of their website.

“Your company has contributed to student loan borrowers’ difficulties by mishandling borrowers’ return to repayment following the COVID-19 pandemic-related pause on payments, interest, and collections and by impeding public servants’ access to PSLF relief,” wrote Warren in the letter.

The move from Warren comes after the U.S. Department of Education withheld $7.2 million in payments to its servicer Mohela in October as punishment because it failed to issue timely billing statements to 2.5 million borrowers which resulted in 800,000 borrowers becoming delinquent on their loans. The department ordered Mohela to put those affected by the issues into forbearance until the mess was resolved.

U.S. President Joe Biden is joined by Education Secretary Miguel Cardona (L) as he announces new actions to protect borrowers after the Supreme Court struck down his student loan forgiveness plan in the Roosevelt Room at the White House on June 30, 2023 in Washington, DC. 

Chip Somodevilla/Getty Images

Mohela is also currently facing two class-action lawsuits, one filed in December last year and another in January this year, for its alleged “failure to timely process and render decisions for student loan borrowers enrolled in the Public Service Loan Forgiveness program.”

In response to recent criticism surrounding its alleged issues and failures regarding the PSLF program, Mohela claimed in a statement to the Missouri Independent that it “does not have authority to process loan forgiveness until authorization is provided by FSA, which can take months to occur.”

The company also claimed that there are “false accusations” inside of the bombshell report, which was released in February, that details the company’s servicing failures.

“It is unfortunate and irresponsible that information is being spun to create a false narrative in an attempt to mislead the public. False accusations are being disingenuously branded as an investigative report,” said Mohela. 

Related: Amazon just made a major announcement that will bring you big savings — and we have all the details

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International

Bolsonaro Indicted By Brazilian Police For Falsifying Covid-19 Vaccine Records

Bolsonaro Indicted By Brazilian Police For Falsifying Covid-19 Vaccine Records

Federal police in Brazil have indicted former President Jair…

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Bolsonaro Indicted By Brazilian Police For Falsifying Covid-19 Vaccine Records

Federal police in Brazil have indicted former President Jair Bolsonaro for falsifying his Covid-19 vaccine card in order to travel to the United States and elsewhere during the pandemic.

Federal prosecutors will review the indictment and decide whether to pursue the case - which would be the first time the former president has faced criminal charges.

According to the indictment, Bolsonaro ordered a top deputy to obtain falsified Covid-19 vaccine records of himself and his 13-year-old daughter in late 2022, right before he flew to Florida for a three-month stay following his election loss.

Brazilian police are also waiting to hear back from the US DOJ on whether Bolsonaro used said cards to enter the United States, which would open him up to further criminal charges, the NY Times reports.

Bolsonaro has repeatedly claimed not to have received the Covid-19 vaccine, but denies any involvement in a plan to falsify his vaccination records. A previous investigation by Brazil's comptroller general concluded that Bolsonaro's vaccination records were false.

The records show that Bolsonaro, a COVID-19 skeptic who publicly opposed the vaccine, received a dose of the immunizer in a public healthcare center in Sao Paulo in July 2021. [ZH: hilarious, Reuters calling the vaccine an 'immunizer.']

The investigation concluded, however, that the former president had left the city the previous day and didn't leave Brasilia until three days later, according to a statement.

The nurse listed in the records as having applied the vaccine on Bolsonaro denied doing so and was no longer working at the center. The listed vaccine lot was also not available on that date, the comptroller general's office said. -Reuters

"It's a selective investigation. I'm calm, I don't owe anything," Bolsonaro told Reuters. "The world knows that I didn't take the vaccine."

During the pandemic, Bolsonaro panned the vaccine - and instead insisted on alternative treatments such as Ivermectin, which has antiviral properties against Covid-19. For this, he was investigated by Brazil's congress, which recommended that the former president be charged with "crimes against humanity," among other things, for his actions during the pandemic.

In May, Brazilian police raided Bolsonaro's home, confiscating his cell phone and arresting one of his closest aides and two of his security cards in connection to the vaccine record investigation.

Brazil's electoral court ruled that Bolsonaro can't run for public office until 2030 after he suggested that the country's voting system was rigged. For that, he has to sit out the 2026 election.

Tyler Durden Tue, 03/19/2024 - 11:00

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International

This gambling tech stock is future-proofing the world’s casinos

Supported by the universal thrill of a quick payout and the need for leisure, gambling stocks make a compelling case for long-term returns.
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Supported by the universal human thrill of a quick payout, and the need for leisure and entertainment to bring enjoyment to adult life, casinos will remain essential spaces for people to dream and play for the foreseeable future, making gambling stocks a prospective space to look for long-term returns.

According to Research and Markets, the global casino industry was valued at US$157.5 billion in 2022, and it will grow to US$224.1 billion by 2030 at a compound annual growth rate of 4.5 per cent. This trend includes:

Approximately 100 million gamblers in the United States, who generated US$66.5 billion in revenue in 2023, a 10 per cent gain from 2022, which itself was a record year A little fewer than 20 million gamblers in Canada, who generated about C$15 billion in revenue in 2023 A global addressable market of thousands of casinos, and more than 4.2 billion people who gamble at least once every year, according to a 2016 study by Casino.org

The main challenge with attracting these billions through casino doors is they sway heavily toward middle age. The mean age of U.S. casino visitors has hovered around 50 for the past decade, with a similar trend across the world, forcing casinos to attract younger, tech-savvy customers, many with less gambling experience, to continue growing profits for their stakeholders over the long term.

Investors seeking exposure to a leadership position in building the bridge between casinos and the next generation of gamblers should evaluate Jackpot Digital (TSXV:JJ). The Vancouver-based company is a manufacturer of dealerless electronic table games that deliver immersive experiences tailored to the digital age, while earning casinos attractive returns on investment.

The gambling technology stock benefits from no direct competition in the dealerless poker space, with orders spanning North America, Europe, Asia, Africa and the Caribbean, a long-established presence with major cruise ship brands, such as Carnival, Princess Cruises and Holland America, and a growing land-based presence with orders or ongoing installations across 12 U.S. states. Its highlight partnership to date is a master services agreement with Penn Entertainment, the country’s largest regional gaming operator with 43 properties across 20 states.

Jackpot Digital’s differentiated technology and well-rounded management team are at the heart of its success in landing several blue-chip casino gaming companies as customers.

Jackpot Blitz

The gambling technology stock’s flagship product, Jackpot Blitz, is a dealerless poker table featuring three of the world’s most popular variations – Texas Hold’ em, Omaha, and Five-Card-Omaha – brought to life through slick 4k graphics on a 75-inch touchscreen, and offered in three formats – pot-limit, no-limit and fixed-limit – designed to attract a diversity of revenue from casual to experienced players.

Spokesperson and NFL championship-winning coach Jimmy Johnson explains the benefits of the Jackpot Blitz. Source: Jackpot Digital.

The table also comes equipped with house-banked mini-games, including blackjack, baccarat and video poker, as well as side bets on the main poker game, such as Bet the Flop, all of which keep players engaged and entertained between, and even during, poker hands. The stunning Jackpot Blitz machine also offers multi-venue “Bad Beat” jackpot functionality, allowing casinos to offer a “Poker Powerball” with massive Jackpots, further enhancing the attractiveness of Jackpot Blitz to new players.

It’s by striking a balance between the needs of the modern gambler, and efficiency and profitability that in-person operators couldn’t hope to match – unless they ordered the machine for themselves – that Jackpot Digital has earned itself the top spot in dealerless poker.

Player benefits

When a veteran or novice gambler takes a seat at the Jackpot Blitz, his or her experience begins with an easy-to-use interface, laid out in a modern and stylish design, programmed to respond to hand gestures that bring real casino play into the digital age, including card bending and chip jingling.

Source: Jackpot Digital.

The table’s intuitive controls, combined with instant payouts and its dealerless nature, translate into faster game play, which maximizes playing time and player excitement, while minimizing human error and the intimidation new gamblers might feel about approaching an analog poker table. The gambling technology stock’s in-house development team is also constantly working on new games to keep content fresh, with a special focus on bringing international games and regional versions of poker to casino audiences in Asia, South America and the Indian subcontinent.

As hands are laid down and pots pile up, players can also track game stats in real time, which inform future strategy and enhance the thrill of the moment with an added element of competition.

Operator benefits

From an operator’s perspective, a floor of automated gaming tables can meaningfully and instantly reduce casino staff expenditures and management pain points, while avoiding wage inflation, labour shortages and supply costs.

The Blitz is no slouch on revenue either, dealing more hands per hour, resulting in higher revenue and higher profitability, which is further enhanced by onboard side bets and mini-games that can be played while players are engaged in a poker hand.

The Jackpot Blitz’s economics are attractive to operators thanks to its ability to accommodate non-stop play, while monetizing downtime through side games and bets. While a human dealer must spend time shuffling, interacting with players, and consulting with colleagues, the Jackpot Blitz can accept wagers 100 per cent of the time, making sure gamblers get the action they came for and operators see a return on their investment.

Source: Jackpot Digital.

Beyond gaming revenue, casinos are further incentivized to onboard the Jackpot Blitz because of its fully customizable advertising functions, including logos, card backs, chips and felt colors, all of which bolster casino culture and enable the pursuit of revenue from third-party advertising partners.

The Blitz ties its value proposition together by generating automatic reports – including demographics and consumer behaviour through a rewards card system – and plugging directly into most back-end management systems, saving casinos the hassle of manual tracking, while also minimizing tampering, money-laundering and theft through the use of isolated servers.

Whether it’s streamlining the player experience or putting automation at the service of operators’ bottom lines, Jackpot Digital’s flagship product is positioned to create value, and plenty of it.

Jackpot Digital’s path to profitability

After existing as an exclusively cruise-ship-based operation since 2015, Jackpot Digital suffered a steep decline in revenue during the COVID pandemic, falling from C$2.18 million in 2019 to C$0.42 million in 2021.

Management quickly pivoted in the face of uncertainty, redesigning the Blitz to execute on a land-based expansion strategy – backed by Gaming Labs International certification in fall 2023 – which is bringing about a successful turnaround after the re-emergence of the casino business. Revenue more than tripled to C$1.43 million in 2022, and reached C$1.57 million through three quarters of 2023, with the company expecting to ramp up significant recurring revenue after it installs several dozen machines currently in its backlog.

The Jackpot Blitz electronic gaming table in action. Source: Jackpot Digital.

The first installation of land-ready Jackpot Blitz machines is now completed at the Jackson Rancheria Casino in California, as the company announced today. The three-machine installation marks a new era of growth for the company, having announced 25 Blitz deals since November 2021 (slide 12), with many more across Canada and the United States in the works, in addition to a strong pipeline in Asia and Europe.

“Jackpot Digital could be a profitable company right now if it only focused on care and maintenance of the revenues it currently generates. But that’s not why we’re here,” Mathieu McDonald, Vice President of Corporate Development at Jackpot Digital, said in a recent interview with Stockhouse. “We intend to scale up to many multiples of the tables we have out right now, with the potential for up to 2,000 tables over the next three to five years.”

According to McDonald, the company is fielding three to five inquiries per week about the Blitz from casinos around the world that recognize the machines’ first-mover advantage in dealerless poker and potential expansion into other games in need of automation.

Jackpot Digital’s ambitious plan of action is supported by a management team of proven gambling, finance, advertising and legal professionals, many of which have been serving Jackpot stakeholders for more than two decades.

A long-tenured management team

The management team behind Jackpot Digital is led by Jake Kalpakian, who has served as president and chief executive officer since 1999, including under the gambling technology stock’s former incarnation as Las Vegas From Home.com Entertainment Inc. Kalpakian brings more than 30 years of experience managing small-cap publicly listed companies, granting him a steady hand when it comes to maneuvering through the volatility of the economic cycle.

Kalpakian’s efforts are supported by three directors whose well-rounded expertise positions Jackpot Digital for long-term sustainable growth:

Gregory T. McFarlane, a director at Jackpot Digital since 1999, previously ran an independent advertising firm and holds a degree in mathematics from the University of Toronto. McFarlane is also a co-founder of the popular Control Your Cash personal finance website. Chief financial officer Neil Spellman, a director at the company since 2002, boasts an almost two-decade track record as vice president at Wall Street firm Smith Barney, where he developed a multi-industry understanding of the journey to profitability. Finally, Alan Artunian, a director since 2017, currently serves as CEO of Nice Guy Holdings, a corporate and legal consulting company advising clients across a diversity of sectors.

Guided by a strategic management team, and benefiting from a macro-trend toward casino automation, Jackpot Digital is on course to ride a wave of millions of gamblers looking for an elegant, tech-informed alternative to traditional in-person play.

A multi-bagger opportunity

The Jackpot Digital opportunity sets up savvy investors who recognize the soundness of the company’s value proposition. The tremendous risk/reward value of Jackpot Digital gives investors the opportunity to ride the macro-trend toward casino automation, as deals for the Blitz keep pouring in, the company adds games to its portfolio, and the global casino industry adds hundreds of billions in revenue through this decade.

Join the discussion: Find out what everybody’s saying about this gambling technology stock on the Jackpot Digital Bullboard.

This is sponsored content issued on behalf of Jackpot Digital, please see full disclaimer here.

The post This gambling tech stock is future-proofing the world’s casinos appeared first on The Market Online Canada.

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