According to Axois:
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. 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.