Almost 1 million prime-age Americans were dragged out of the 2015 labor force by Chinese-supplied fentanyl, Mexican heroin and U.S-made prescription opioid drugs, says a report by the American Action Forum, a business-first advocacy group.

The economic impact of this opioid drug disaster adds up to $91 billion in lost productivity during 2015, alongside 42,000 deaths in 2016, says the group, which also advocates for easier migration of foreign workers.

The report shows that 4 million prime American men and women — aged 25 to 54 — left the workforce between 1999 and 2015. The huge departure has been blamed on trade, on technology and the decline in blue-collar wages, and it accelerated in 2008 when the economy collapsed because of the government’s risky and bipartisan push to expand home-ownership.

Overall, roughly one-quarter of the 4 million Americans who quit the workforce were also entangled in drugs, says the AAF report, which does not offer any recommendations for fixing the drug-and-workforce problem.

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