ArticleBMC psychiatry2021
Unemployment rate, opioids misuse and other substance abuse: quasi-experimental evidence from treatment admissions data.
Article in BMC psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 40 citations in OpenAlex.
- Despair is Not Hopelessness: Autonomy and Behavioral Interventions for Deaths of Despair.Public health ethics · 2026Article
- County-Level Variation in Substance Use Disorder Service Utilization by Insurance Payers and Self-Pay in the United States.The Journal of clinical psychiatry · 2026Article
- Substance use and treatment utilization patterns of working-age American men who were not in employment, education, or training (NEET) during the COVID-19 pandemic.Substance abuse treatment, prevention, and policy · 2026Article
- Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990-2023: a Global Burden of Disease Study.Nature medicine · 2026Article
- Substance use and treatment utilization patterns of working-age American men who were not in employment, education, or training (NEET) during the COVID-19 pandemic.Research square · 2026Article
- Engaging veterans in the development of mobile health interventions to support medication treatment for opioid use disorder.Frontiers in digital health · 2026Article
- Substance use and treatment utilization patterns of working-age American men who were not in employment, education, or training (NEET) during the COVID-19 pandemic.medRxiv : the preprint server for health sciences · 2025Article
- Association Between Unemployment and Mental Disorders: A Narrative Update of the Literature.International journal of environmental research and public health · 2024Review
- Patterns and social factors associated with non-prescription use of Tramadol: a cross-sectional study among youth in urban informal settlements in Ghana.Journal of health, population, and nutrition · 2024Article
- Kharameh cohort study (KHCS) on non-communicable diseases and preliminary findings of 3-year follow-up.BMJ open · 2024Article
- Evaluation of the Psychiatric Disorders among Amphetamine Addicts in Rehabilitation Centers: A Cross-Sectional Analysis.Journal of toxicology · 2024Article
- Impact of community mental health services on the adult psychiatric admission through the emergency unit: a 20-year population-based study.The Lancet regional health. Western Pacific · 2023Article
- Typology of laws restricting access to methadone treatment in the United States: A latent class analysis.The International journal on drug policy · 2023Article
- Unemployment and Substance Use: An Updated Review of Studies from North America and Europe.Healthcare (Basel, Switzerland) · 2023Review
- Associations between relative deprivation with opioid use among working-age adults during the great recession.Journal of psychiatric research · 2023Article
- A 6-Month Follow-Up Study: Cognitive Impairment May Predict More Frequent Use of Methamphetamine.Substance abuse : research and treatment · 2023Article
- Evaluation of Substance Use Disorder Readmission and Length of Hospital Stay in a Major Rehabilitation Center in the Gulf States: a Retrospective Cohort Study.International journal of mental health and addiction · 2022Article
- The Effect of Vocational Counseling Interventions for Adults with Substance Use Disorders: A Narrative Review.International journal of environmental research and public health · 2022Review
- Problem drinking as intentional risky behavior: Examining the association between state health insurance coverage and excessive alcohol consumption.Preventive medicine reports · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe relationship between economic conditions and substance abuse is unclear, with few studies reporting drug-specific substance abuse. The present study examined the association between economic conditions and drug-specific substance abuse admissions.
methodsState annual administrative data were drawn from the 1993-2016 Treatment Episode Data Set. The outcome variable was state-level aggregate number of treatment admissions for six categories of primary substance abuse (alcohol, marijuana/hashish, opiates, cocaine, stimulants, and other drugs). Additionally, we used a broader outcome for the number of treatment admissions, including primary, secondary, and tertiary diagnoses. We used a quasi-experimental approach -difference-in-difference model- to estimate the association between changes in economic conditions and substance abuse treatment admissions, adjusting for state characteristics. In addition, we performed two additional analyses to investigate (1) whether economic conditions have an asymmetric effect on the number of substance use admissions during economic downturns and upturns, and (2) the moderation effects of economic recessions (2001, 2008-09) on the relationship between economic conditions and substance use treatment.
resultsThe baseline model showed that unemployment rate was significantly associated with substance abuse treatment admissions. A unit increase in state unemployment rate was associated with a 9% increase in treatment admissions for opiates (β = 0.087, p < .001). Similar results were found for other substance abuse treatment admissions (cocaine (β = 0.081, p < .001), alcohol (β = 0.050, p < .001), marijuana (β = 0.036, p < .01), and other drugs (β = 0.095, p < .001). Unemployment rate was negatively associated with treatment admissions for stimulants (β = - 0.081, p < .001). The relationship between unemployment rate and opioids treatment admissions was not statistically significant in models that adjusted for state fixed effects and allowed for a state- unique time trend. We found that the association between state unemployment rates and annual substance abuse admissions has the same direction during economic downturns and upturns. During the economic recession, the negative association between unemployment rate and treatment admissions for stimulants was weakened.
conclusionThese findings suggest that economic hardship may have increased substance abuse. Treatment for substance use of certain drugs and alcohol should remain a priority even during economic downturns.
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