This study examines the effects of prescription opioid analgesic use for older Americans, specifically with regard to work disability and disability program participation. We draw on the long-panel structure of the Health and Retirement Study and a newly available 2009 survey module measuring prescription drug use and initiation. We pursue regression-adjustment and nearest neighbor matching approaches, using rich 2008 HRS measures on health, disability, sociodemographic characteristics, and economic status, to account for selection into prescription opioid use, since supply-side instruments used in the opioid literature have little relevance to opioid use for this population in 2009. Pre-2008 comparisons between individuals with 2009 opioid prescriptions and controls demonstrate face validity of the analytic approach; we then estimate opioid use effects on mortality, self-reported health, labor force participation, work-limiting health conditions, and disability program participation, spanning from 2010 to 2018. We find substantial and significant mortality effects starting in 2010; in estimating effects on other outcomes, we account for differential attrition through mortality via inverse probability reweighting. Our findings are significant, both statistically and economically: up through 2018, individuals with 2009 opioid prescriptions were nearly 40% more likely to develop a health condition that limited their ability to work than those without a prescription. This difference in work disability led to substantial differences in disability program participation: those using opioids were nearly 300% more likely to apply for or receive Social Security disability benefits by 2018.