UNDERSTANDING STRESS AS A POTENTIAL MECHANISM BETWEEN POVERTY EXPERIENCES ACROSS THE LIFE-COURSE AND ILLICIT SUBSTANCE USE IN EARLY MID-LIFE

Introduction: Illicit substance use contributes substantially to morbidity and mortality in the United States, and people who experience poverty in various forms are more likely to face adverse drug related outcomes. However, more research is needed to understand how poverty may be related to the incidence of illicit substance use, underlying mechanisms, and variations by drug class. Methods: I used Waves I, IV, and V from the National Longitudinal Study of Adolescent to Adult Health to explore the relationship between poverty and illicit substance use in adjusted generalized structural equation models. In Study One, I assessed whether experiencing poverty across the life-course was related to illicit substance use at early mid-life. In Study Two, I analyze perceived and chronic stress as mechanisms between poverty and illicit substance use. Results: In Study One, adolescent poverty was associated with a higher likelihood of prescription painkiller use, and early adult poverty mediated the relationship between adolescent poverty and both prescription painkiller use and methamphetamine use. In Study Two, I found that people who experienced poverty in adolescence were more likely to experience poverty in early adulthood, which was subsequently associated with greater perceived stress, which was in turn associated with higher likelihoods of any illicit use, prescription painkiller use, prescription sedative use, prescription tranquilizer use, and prescription stimulant use not as prescribed by a doctor. No effects were detected with respect to other illicit substance use variables. Conclusions: Adolescent poverty was related to illicit substance use later in life, though differences existed by drug class, and effects were largely the result of an indirect effect through poverty in early adulthood. I also found evidence to suggest that perceived stress is an underlying mechanism for certain drugs, indicating intervention efforts targeting negative affect could be useful to reducing use. Efforts to reduce the cyclical nature of poverty may also be beneficial to reducing the likelihood of substance use and adverse drug outcomes downstream.