Heterogeneous Trajectories in Post-Disaster Drug Use Across Different Race/Ethnicity and Income Strata: Focus on Natural Hazards During COVID-19.

During the COVID-19 pandemic, climate-related natural hazards, such as wildfires, storms/hurricanes, and others (e.g., earthquakes, tornadoes), further disrupted the normal functioning of US residents. The co-occurrence of natural disasters and COVID-19 created unprecedentedly elevated levels of stress, especially to the racial/ethnic minorities and lower-income households. This study examines how natural disasters related to recreational drug use during COVID-19 and whether the relation is heterogeneous across different subgroups categorized by race/ethnicity and household income. This study used the data from the biweekly online surveys of the Understanding America Study (UAS) and analyzed the drug use behaviors of 966 US adults between April 29 and December 31, 2020. This study found that middle-income adults (household income ranging from $50,000 to $149,999), serving as the reference group, generally exhibited a significant reduction in drug consumption during or after disaster events. However, compared to the middle-income group, White and Black adults with household income lower than $50,000 showed 142% and 88% more frequent drug use when experiencing storms/hurricanes. This disparity widened in the following weeks. Additionally, lower-income Hispanics showed 74% more frequent drug use compared to the middle-income group in the weeks following wildfire incidents. The study's findings shed light on the risk of drug misuse during the co-occurrence of climate and public health crises, emphasizing the disproportionate risk among lower-income racial/ethnic minorities amid the pandemic and natural disasters.