Drug Policy Research Center Substance Use and Recessions: Insights from Economic Analyses of Alcohol and Drug Use Rosalie Liccardo Pacula, Ph.D. Co-Director RAND Drug Policy Research Center Senior Economist, RAND Recent global recession and financial crisis decimated national budgets Gross public debt as % of GDP 100 90 80 70 60 50 Economy: 40 World 30 Advanced 20 10 Emerging 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: IMF Drug Policy Research Center October 2011 2 Vulnerable populations affected by reduced services • Elderly • Poor • Youth • People suffering from chronic physical and mental health conditions – Addiction is *finally* understood as a chronic disease amongst the scientific and medical communities – Making inroads with policy makers Drug Policy Research Center October 2011 3 What We Know about Economic Recessions and Substance Use • Most people familiar with the psychological mechanisms on behavior – Recession Stress more use – Recession Risk taking more dangerous use • Also people are aware of budget cuts impacting prevention and treatment • So, general belief is that use of alcohol and illicit drugs as well as addiction rise during economic downturns • But, economics literature shows heavy alcohol use falls during recessions and only light use rises. Drug Policy Research Center October 2011 4 The Global Recession: Not Your Typical Business-Cycle Fluctuation • Wealth, not just disposable income, dropped dramatically at the beginning of the recession and continues to be affected – Housing bubble experienced in several key consuming countries – Drop in value of investments traded in financial markets through mortgage-backed securities Drug Policy Research Center October 2011 5 Global Recession Was Deeper for Advanced Economies 10 % change in real GDP Economy: World Advanced 8 Emerging 6 4 2 0 -2 -4 1980 1985 Drug Policy Research Center 1990 1995 2000 2005 2010 Source: IMF October 2011 6 Unemployment in Advanced Economies Increased After Global Recession 10 % change in real GDP % unemployed 8 6 4 2 0 -2 -4 1980 % unemployed % change in GDP 1985 Drug Policy Research Center 1990 1995 2000 2005 6 5 4 3 2 1 0 -1 -2 -3 -4 -5 2010 Source: IMF October 2011 7 Outline • Economic mechanisms that may affect alcohol and drug use and addiction • Effects of business-cycle fluctuations on alcohol use • Effects of business-cycle fluctuations on illicit-drug use • Policy implications Drug Policy Research Center October 2011 8 Outline • Economic mechanisms that may affect alcohol and drug use and addiction • Effects of business-cycle fluctuations on alcohol use • Effects of business-cycle fluctuations on illicit-drug use • Policy implications Drug Policy Research Center October 2011 9 Two important economic drivers impacted by business cycle fluctuations • Disposable Income • Relative Prices Drug Policy Research Center October 2011 10 How Recessions May Decrease Consumption of Alcohol and Illicit Drugs Economic recession Lower personal disposable income Lower consumption of all goods, including alcohol and illicit goods Drug Policy Research Center October 2011 11 How Recessions May Decrease Consumption of Alcohol and Illicit Drugs Economic recession Lower personal disposable income “Income Effect” Lower consumption of all goods, including alcohol and illicit goods Drug Policy Research Center October 2011 12 How Recession May Decrease Consumption of Alcohol and Illicit Drugs Economic recession Lower personal disposable income Change in relative prices Lower consumption of all goods, including alcohol and illicit goods Drug Policy Research Center October 2011 13 How Recession May Decrease Consumption of Alcohol and Illicit Drugs Economic recession Lower personal disposable income Change in relative prices 1. Price of leisure time Lower consumption of all goods, including alcohol and illicit goods Drug Policy Research Center 2. Monetary price of drug A October 2011 14 What Has Research Shown on Price of Alcohol and Drugs in Recession? • In recessionary times, price of alcohol is flat or increases – No evidence manufacturers lower prices during recessions – Governments may increase “sin” taxes, which may get passed through to alcohol prices • Price of illicit drugs theoretically could fall – There is no empirical evidence supporting a drop in illicit drug prices associated with recent global recession Drug Policy Research Center October 2011 15 UK Cocaine Price Has Been Steady Recently While Price for Crack Rose Sharply in 2009 £ per gram 70 Cocaine Crack 60 50 40 30 20 10 0 2004 2005 Drug Policy Research Center 2006 2007 2008 2009 Source: Independent Drug Monitoring Unit October 2011 16 UK Cannabis Prices Have Increased for Some Varieties £ per gram 160 2005 2006 2007 2008 2009 140 120 100 80 60 40 20 0 Black Drug Policy Research Center Soap-Bar Skunk Imported Bush Source: Independent Drug Monitoring Unit October 2011 17 How Recession May Decrease Consumption of Alcohol and Illicit Drugs Economic recession Lower personal disposable income Change in relative prices Lower consumption of all goods, including alcohol and illicit goods Lower price of leisure might increase or decrease consumption Drug Policy Research Center October 2011 18 Outline • Economic mechanisms that may affect alcohol and drug use and addiction • Effects of business-cycle fluctuations on alcohol use • Effects of business-cycle fluctuations on illicit-drug use • Policy implications Drug Policy Research Center October 2011 19 Relationship Between Economic Conditions and Alcohol Use Is Nuanced • Initial research found U.S. states with higher rates of unemployment had lower rates of total alcohol consumption and alcohol-related deaths • Subsequent research found difference between “heavy” and “light” drinking during recessions – Heavy drinking behavior is pro-cyclical, decreasing during recessions – Some evidence light drinking may be countercyclical • When modeled carefully, same results have been found for Europe (Gerdtham & Ruhm, 2006) Drug Policy Research Center October 2011 20 U.S. Trends in Employment, Smoking, and Obesity Have Similar Cyclical Patterns Drug Policy Research Center Source: Ruhm, 2005 October 2011 21 Outline • Economic mechanisms that may affect alcohol and drug use and addiction • Effects of business-cycle fluctuations on alcohol use • Effects of business-cycle fluctuations on illicit-drug use • Policy implications Drug Policy Research Center October 2011 22 Unemployment Boosts Cannabis and Other Drug Use Among U.S. Youths Estimated effects of unemployment rate on youth drug use Coefficient estimate for persons age 15 to 19 20 to 24 Used cannabis in past year 0.067* 0.080*** Used cannabis in past month 0.059 0.131*** Heavy use of cannabis in past month 0.116*** 0.209*** Times used cannabis in past month 0.096** 0.174*** Used other drugs in past year 0.165*** 0.015 Heavy use of other drugs in past year 0.129* 0.017 Times used other drugs in past month 0.211* 0.218 * indicates statistical significance at the 10% level ** indicates statistical significance at the 5% level *** indicates statistical significance at the 1% level Source: Arkes, 2011 Drug Policy Research Center October 2011 23 Unemployment Boosts Cannabis and Other Drug Use Among U.S. Youths Estimated effects of unemployment rate on youth drug use Coefficient estimate for persons age 15 to 19 20 to 24 Used cannabis in past year 0.067* 0.080*** Used cannabis in past month 0.059 0.131*** Heavy use of cannabis in past month 0.116*** 0.209*** Times used cannabis in past month 0.096** 0.174*** Used other drugs in past year 0.165*** 0.015 Heavy use of other drugs in past year 0.129* 0.017 Times used other drugs in past month 0.211* 0.218 * indicates statistical significance at the 10% level ** indicates statistical significance at the 5% level *** indicates statistical significance at the 1% level Source: Arkes, 2011 Drug Policy Research Center October 2011 24 Unemployment Boosts Cannabis and Other Drug Use Among U.S. Youths Estimated effects of unemployment rate on youth drug use Coefficient estimate for persons age 15 to 19 20 to 24 Used cannabis in past year 0.067* 0.080*** Used cannabis in past month 0.059 0.131*** Heavy use of cannabis in past month 0.116*** 0.209*** Times used cannabis in past month 0.096** 0.174*** Used other drugs in past year 0.165*** 0.015 Heavy use of other drugs in past year 0.129* 0.017 Times used other drugs in past month 0.211* 0.218 * indicates statistical significance at the 10% level ** indicates statistical significance at the 5% level *** indicates statistical significance at the 1% level Source: Arkes, 2011 Drug Policy Research Center October 2011 25 Youths Who Use Illicit Drugs Are More Likely to Sell Them in Economic Recession • Teenagers face higher risk of unemployment when economy contracts Drug Policy Research Center October 2011 26 Youth Unemployment in the UK Is Greater than Total Unemployment 25 % unemployed UK total UK 18-24 20 15 10 5 0 2008-III 2008-IV 2009-I 2009-II 2009-III 2009-IV 2010-I 2010-II 2010-III 2010-IV 2011-I 2011-II 2011-III* Year and quarter Sources: UK Office for National Statistics, US Bureau of Labor Statistics. 2011-III data fur UK for June-August 2011. Drug Policy Research Center October 2011 27 Youth Unemployment in the United States Is Also Far Greater than Total Unemployment 30 % unemployed US total US 16-19 25 20 15 10 5 0 2008-III 2008-IV 2009-I 2009-II 2009-III 2009-IV 2010-I 2010-II 2010-III 2010-IV 2011-I 2011-II 2011-III* Year and quarter Sources: UK Office for National Statistics, US Bureau of Labor Statistics. 2011-III data fur UK for June-August 2011. Drug Policy Research Center October 2011 28 Youths Who Use Illicit Drugs Are More Likely to Sell Them in Economic Recession • Teenagers face higher risk of unemployment when economy contracts • Hypotheses for why they seek/obtain jobs in black market: – Social networks facilitate it – Youth have lower rates of risk-aversion – Black market actively recruits youth sellers – Enforcement reduced • Implications: – Teens able to partially or fully offset income lost from legitimate market employment – Teens learn where to buy drugs at lower prices Drug Policy Research Center October 2011 29 Similar Age Differences Observed in Australian Household Survey Data Predicted Effect of 1-percent increase in unemployment $1,000 increase in per capita income -1.9 % decrease -0.8% decrease On cannabis use by Total population 14-24 year-olds 2.4% increase 0.2% increase 25-34 year-olds 1.4% increase 0.2% increase Source: Chalmers and Ritter, 2011 Drug Policy Research Center October 2011 30 Why Does Relationship Between Economy and Illicit Drugs Use Differ by Age? • Youth may be more willing than adults to engage in black-market alternatives during economic slowdowns – Participating in black markets can result in no real loss in general income – Clear evidence supporting this interpretation in the United States, but additional research needed on other developed countries • Psychological mechanisms associated with recessions may dominate economic mechanisms for this segment of the population Drug Policy Research Center October 2011 31 Outline • Economic mechanisms that may affect alcohol and drug use and addiction • Effects of business-cycle fluctuations on alcohol use • Effects of business-cycle fluctuations on illicit-drug use • Policy implications Drug Policy Research Center October 2011 32 Research Offers Several Insights for Policy • Evidence pointing to decrease in heavy use of alcohol and illicit drugs among older adults may mean short-term cuts in treatment budgets not as important as cuts in prevention right now • Rise in illicit drug use among youth & young adults means need for future treatment will rise, however – Budget cuts for treatment must only be temporary • Youths are particularly vulnerable in recessions – Vulnerable to initiating drug use – Vulnerable to engaging in black market activities Drug Policy Research Center October 2011 33 Main Conclusion • Both psychological and economic factors influence consumption during economic downturns • There is heterogeneity in which factor dominates a given population’s behavior • For the population on average, income effects seem to dominate psychological factors for heavy drinking • Several social factors might change the relative importance of income effects: – System of social insurance in a country – Intensity and duration of recession – Ability of a country to borrow during recessions to maintain enforcement & programs Drug Policy Research Center October 2011 34 Thank you!! Drug Policy Research Center October 2011 35