With a growing economy, low unemployment rate and thousands of new jobs being created, manufacturing companies are being hit by potential employees failing pre-employment drug tests. The abuse of opioids and growing use of marijuana has resulted to half of applicants in the upper-Midwest failing their drug tests. Companies like Columbiana Boiler in Ohio are losing business to overseas rivals because of labor shortages. Failed pre-employment drug tests in Ohio are now at least 25% of applicants, consequently participation in the workplace is declining and small, rural economies are feeling the strain. Ohio has been hit the hardest by opioid overdose deaths because of the overabundance of prescribed opioids in the state. Passing drug tests in the Midwest is not the only financial impact, employees who become addicted to opioids while they are working is increasing health coverage rates for employers because of the high cost of drug treatments. Drug treatment costs can range from $1000 to $60,000 per person.