Substance use disorders (SUDs) are associated with substantial costs to affected individuals, their families, and society. An estimated 107,000 Americans died as the result of an overdose in 2021 [1]. In 2016, alcohol use contributed 4.2% to the global disease burden and other drug use contributed 1.3% [2]. Excessive alcohol use and illicit drug use cost the United States an annual $250 billion [3] and $190 billion [4] respectively. Given the substantial human and economic costs of substance misuse and disorders, understanding the combined impact of important risk factors across multiple levels of analysis has important public health implications.
