Racial/Ethnic disparities in drug use during the COVID 19 pandemic: Moderating effects of non-profit substance use disorder service expenditures

The COVID-19 pandemic influenced individuals’ anxiety and depression across the United States over a short period, and some Americans relied on drugs for coping. This study examines American adults’ drug use trajectories in response to changing anxiety and depression levels during the COVID-19 pandemic and the moderating role of substance use disorder (SUD) services provided by non-profit facilities in anxiety/depression-induced drug use. Heterogeneity in such relationships is further explored based on race/ethnicity. This study used a nationally representative sample of 1,176 American adults who reported drug use between May 1, 2020, and June 30, 2021. Using individual-fixed effects Poisson estimators, the current study empirically modeled drug use changes according to changing anxiety/depression levels. Interaction terms between anxiety/depression levels and per capita spending by non-profit SUD facilities were used to explore the moderating effect of SUD service expenditures. Racial/ethnic disparities were explored in subgroup analyses on non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Asian samples. We found more frequent drug use in response to elevated anxiety and depression during the COVID-19 pandemic. Greater spending on SUD service by non-profit facilities at the county level was associated with reduced drug consumption associated with anxiety and depression, with greater benefits for racial/ethnic minorities. Findings provide important policy implications for distributing public funds for non-profit SUD facilities for mitigating SUD risks, especially among racial/ethnic minorities.