Local industry-specific job shares and methamphetamine use and use disorder among working-aged individuals in the United States, 2015-2019.

OBJECTIVE: As concerns over methamphetamine use grow, structural factors-particularly local labor-market context-may offer insights into geographic patterns. We examine whether county-level industry-specific job shares are associated with methamphetamine use and use disorder among working-aged individuals in the United States. METHODS: We analyzed restricted-use data from the 2015 to 2019 National Survey on Drug Use and Health, including approximately 275,100 nationally-representative individuals aged 15-64. Individual-level data were linked with county- and state-level labor-market and contextual indicators. Logistic regression models with year fixed-effects and a Mundlak random-effects specification were used to adjust for year-specific shocks and persistent county-level heterogeneity, while adjusting for individual sociodemographic and contextual factors. RESULTS: Higher county-level job shares in Utilities, Construction, and Administrative/Support/Waste Management/Remediation Services showed notable associations with elevated odds of methamphetamine use and use disorder. For example, across the 5th to 95th percentiles of county Utilities job shares, the predicted probabilities of use ranged from 0.31% (95% CI:0.27-0.34) to 0.39% (95% CI:0.34-0.43) and from 0.13% (95% CI:0.11-0.15) to 0.16% (95% CI:0.13-0.18) for use disorder. CONCLUSIONS: Local labor-market composition is associated with variation in methamphetamine use outcomes. These findings may help identify labor-market contexts where geographically and sector-specific prevention and treatment efforts may be relevant.