title: The Impact of the 2008 Economic Crisis on Substance Use Patterns in the Countries of the European Union.
abstract: BACKGROUND
  From 2008 on, a severe economic crisis (EC) has characterized the European Union (E.U.). However, changes in substance use behavioral patterns as a result of the economic crisis in Europe, have been poorly reflected upon, and underlying mechanisms remain to be identified;
  
  
  METHODS
  In this review we explore and systematize the available data on the effect of the 2008 economic crisis on patterns of substance use and related disorders, within the E.U. countries;
  
  
  RESULTS
  The results show that effects of the recession need to be differentiated. A number of studies point to reductions in population's overall substance use. In contrast, an increase in harmful use and negative effects is found within specific subgroups within the society. Risk factors include job-loss and long-term unemployment, and pre-existing vulnerabilities. Finally, our findings point to differences between types of substances in their response on economic crisis periods;
  
  
  CONCLUSIONS
  the effects of the 2008 economic crisis on substance use patterns within countries of the European Union are two-sided. Next to a reduction in a population's overall substance use, a number of vulnerable subgroups experience serious negative effects. These groups are in need of specific attention and support, given that there is a real risk that they will continue to suffer negative health effects long after the economic downfall has formally been ended.
authors.affiliation: Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University, Antwerp 2640, Belgium. geert.dom@uantwerpen.be.
authors.forename: Geert
authors.initials: G
authors.lastname: Dom
authors.affiliation: Department of Psychiatry, Pomeranian Medical University, Szczecin 71-460, Poland. samoj@pum.edu.pl.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Samochowiec
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, King's College London, SE5 8AF, UK. sara.evans-lacko@kcl.ac.uk.
authors.forename: Sara
authors.initials: S
authors.lastname: Evans-Lacko
authors.affiliation: The Finnish Association for Mental Health, Helsinki 00240, Finland. Kristian.Wahlbeck@mielenterveysseura.fi.
authors.forename: Kristian
authors.initials: K
authors.lastname: Wahlbeck
authors.affiliation: Medical Sociology and Health Policy, Antwerp University, Antwerp 2640, Belgium. guido.vanhal@uantwerpen.be.
authors.forename: Guido
authors.initials: G
authors.lastname: Van Hal
authors.affiliation: Personal Social Services Research Unit, London School of Economics and Political Science, London WC2A 2AE, UK. D.Mcdaid@lse.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: McDaid
mesh_terms: D057172:Economic Recession; D005060:Europe / Q000453:epidemiology; D005062:European Union; D006801:Humans; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000191:economics* / Q000453:epidemiology* / Q000209:etiology; D014478:Unemployment
keywords: European Union; alcohol; drugs; economic crisis; nicotine; substance use