At the onset of COVID-19, U.S. labor-force participation fell by about 3 percentage points and remained below pre-pandemic levels three years later. Recovery was slower in states hit harder by the pre-pandemic opioid crisis, measured by age-adjusted overdose death rates. An event study shows that a one-standard-deviation increase in pre-COVID opioid deaths led to a 0.9 percentage point drop in post-COVID labor participation. This effect wasn't due to differences in overall health across states and was stronger among those without a college degree. In high-opioid states, slower recovery was linked to more people leaving the workforce due to disability.