# 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

## TL;DR

This study found that NEET men in the U.S. had higher rates of certain drug use disorders during the pandemic, but lower alcohol use disorder, compared to employed men.

## Contribution

The study is the first to examine substance use patterns among NEET men during the pandemic using nationally representative data.

## Key findings

- 11.1% of working-aged men were NEET in 2022, totaling 10.6 million individuals.
- NEET men had higher odds of prescription tranquilizer, methamphetamine, and pain-reliever use disorders.
- NEET men had lower odds of alcohol use disorder compared to non-NEET men.

## Abstract

A growing population of working-aged men are not in employment, education, or training (NEET). The COVID-19 pandemic increased rates of substance use disorders (SUDs) and affected treatment seeking in the general population, but the COVID era substance use patterns among NEET men are unknown.

We estimated the prevalence and correlates of NEET status among working-aged (18–64) men using data from the 2022 National Survey on Drug Use and Health, a nationally representative survey of non-institutionalized individuals in the United States. We developed logistic regression models to examine associations between NEET status and substance use behaviors and treatment engagement, adjusted for sociodemographic factors.

An estimated 11.1% of working-aged men were NEET in 2022 representing 10.6 million individuals. NEET men were significantly more likely to be older, have lower income, be unmarried, and have lower educational attainment and be Non-Hispanic Black compared to non-NEET men. After adjusting for sociodemographic factors, NEET status was significantly associated with higher odds of prescription tranquilizer/sedative use disorder (aOR = 3.54, 1.97–6.37), methamphetamine use disorder (aOR = 3.10, 95% CI: 1.82–5.28), and prescription pain-reliever use disorder (aOR = 2.88, 1.82–4.53), while being inversely associated with alcohol use disorder (aOR = 0.68, 0.54–0.85).

More than 1 in 10 working-aged men were NEET in 2022. Adjusted models showed higher odds of past-year SUDs but lower rates of alcohol use disorder. Targeted interventions should include age-appropriate, culturally tailored, and substance-specific treatment programs to improve public health.