Debt and early midlife substance use and suicidal ideation

The article tests a common model of how different types of debt relate to substance use and suicidal ideation in early midlife. Drawing on data from US adults age 33 through 43 from the National Longitudinal Study of Adolescent to Adult Health, we model how consumption and investment debt relate to four outcomes: opioid painkiller misuse, other drug use, frequent binge drinking, and suicidal ideation. While educational and mortgage debt do not predict higher risk of these outcomes, consumption debt, incurred from sources other than education or housing, is consistently associated with increased risk across all four outcomes. Sensitivity tests do not isolate any compelling evidence of reverse causality, but we cannot conclusively determine that indebtedness causes increased risk of substance use or suicidal ideation. We contend, however, that high levels of consumption debt are consistently associated with behaviors and ideations that are associated with elevated health risk.