During the recent economic crisis, substance use soared among many demographic groups. The rapid rise in prescription drug use has perhaps received the most attention (Warner et al. 2011; Paulozzi 2012), but is hardly the only source for concern. Marijuana use among 18-25 years olds increased from 19.7% in 2008 to 21.4% in 2009 and remained elevated thereafter. Illicit drug use also increased from 4.3% to 7.2% for 50-54 year olds and from 5.0% to 6.6% for 55-59 year olds from 2008 to 2012 (SAMHSA 2013). Similarly for alcohol, from 2006 to 2009, the share of the U.S. adult population reporting that they were current regular drinkers increased from 48 to 52% (Pleis et al. 2007; 2010). Increases were reported across gender and racial/ethnic groups, though larger among younger and more educated populations. By contrast, cigarette use continued its steady decline during the economic crisis. These large increases over a relatively short, but economically difficult, period raise the question of whether the intensity and complexity of the current economic crisis contributed. Just as importantly, it is not yet known the extent to which these increases have contributed to the harms associated with substance use. The goal of this study is to improve our understanding of the impact of the economic crisis on substance use and substance-related outcomes and, furthermore, to understand the extent to which those effects disproportionately impact particular demographic and socioeconomic groups. Unlike the economic periods considered in previous studies, Americans recently faced the worst economic recession since the Great Depression. A full recovery has yet to fully materialize. The unemployment rate, arguably the most cited indicator of economic conditions, remains high. Geographic variation in the timing, depth and other characteristics of the recession was evident in the unemployment rate. Moreover, different demographic groups were disproportionately affected by the crisis. In particular, minority youth suffered the largest increase in unemployment rates. But the depth of the recession has also raised other concerns that the unemployment rate is an incomplete measure of economic conditions. For example, discouraged workers dropping out of the labor market and those who are underemployed because they are working below their skill level or less than they would prefer are not included among the unemployed in this standard measure. We have the unique opportunity to estimate how the economy impacted substance use and related events using rarely-available geographically-identified data from the National Survey on Drug Use and Health (NSDUH). The restricted NSDUH contains detailed questions about drug use and consequences from a large demographically-diverse sample of adults and teenagers and identifies the location and timing of the response. Previous efforts to analyze the effects of the economic crisis on substance use have relied on surveys that were not focused on drug use. Understanding how economic conditions influence these outcomes is an important step toward understanding how policymakers can mitigate their influence and reduce the costs to society.
Understanding how economic conditions and particularly the economic distress of the current recession, impact substance use among adults and youth is critical to mitigating their influence. The proposed study advances this literature by 1) exploitin data not previously available to this literature, but which provide information on a wider variety f substances and demographically diverse sample of adults and teenagers, 2)considering alternative measures of economic conditions that address many shortcomings of the unemployment rate and examining whether their effects are truly linear as has been assumed in the literature, 3) considering whether the effects vary across demographic groups, and 4) (when possible) considering the mechanisms through which these effects operate.
