Richard A. Grucza, Ph.D., MPESaint Louis University Affiliate
I am an epidemiologist with research interest in the social-environmental and genetic determinants of addiction. I lead several studies funded by the National Institutes of Health on the epidemiology of alcohol, tobacco, and marijuana use and on the role of public policy in shaping addictive behavior. Policy-related work conducted by my colleagues and me has been widely disseminated in the lay media and scientific press and has influenced the national conversation on alcohol and tobacco purchase age policies. I was awarded Outstanding Public Health Transdisciplinary Scholar by Washington University’s Institute for Public Health in 2012. I lead a graduate-level course in addiction and addictive behaviors offered by the Masters of Population Health Sciences (MPHS) program and am a member of the Social Sciences and Population Studies (SSPA) study section for NIH grant reviews.
My specific research areas include:
- Examining whether and how tobacco is a contributing risk factor for suicide.
- Policy influences on cannabis use and utilizing cannabis policy change as a natural experiment to study cannabis-related health consequences.
- Trends in adolescent substance use and related risk behaviors: The epidemiology of externalizing behavior.
- Pharmacoepidemiology and outcomes of medication assisted treatment for opioid use disorder.
Downward trends in adolescent substance use disorders may be attributable to a cohesive decline in externalizing behaviors among teens.
Grucza, R. A., Krueger, R. F., Agrawal, A., Plunk, A. D., Krauss, M. J., Bongu, J., Cavazos-Rehg, P. A., Bierut, L. J. Declines in prevalence of adolescent substance use disorders and delinquent behaviors in the USA: a unitary trend? Psychol Med. 2017 Oct 25:1-12. doi: 10.1017/S0033291717002999. [Epub ahead of print]. PMID: 29065935.
Grucza, R. A., Agrawal, A., Krauss, M. J., Bongu, J., Plunk, A. D., Cavazos-Rehg, P. A., Bierut, L. J. Declining prevalence of marijuana use disorders among adolescents in the United States, 2002 to 2013. J Am Acad Child Adolesc Psychiatry. 2016 Jun;55(6):487-494.e6. doi: 10.1016/j.jaac.2016.04.002. Epub 2016 Apr 7. PMID: 27238067.
Increases in the prevalence of marijuana use among adults are smaller than previously reported.
Grucza, R. A., Agrawal, A., Bierut L. J. NESARC findings on increased prevalence of marijuana use disorders-reply: consistent with other sources of information. JAMA Psychiatry. 2016 May 1;73(5):532-3. doi: 10.1001/jamapsychiatry.2016.0244. PMID: 27008529.
Grucza, R. A. Changing demographics of marijuana initiation: bad news or good? Am J Public Health. 2017 Jun;107(6):833-834. doi: 10.2105/AJPH.2017.303804. PMID: 28498750.
The raising of the drinking age to 21 in many U.S. states during the 1970s and 1980s led to numerous long-term public health benefits—including reduced risk for alcoholism, drug use, and several causes of mortality—for the birth cohorts affected by these changes.
Plunk, A. D., Krauss, M. J., Syed-Mohammed, H., Hur, M., Cavazos-Rehg, P. A., Bierut, L. J., Grucza, R. A., (2016 Aug). The impact of the minimum legal drinking age on alcohol-related chronic disease mortality. Alcohol Clin Exp Res. 40(8): 1761-1768. PMID: 27340945.
Krauss M. J., Cavazos-Rehg, P. A., Agrawal, A., Bierut, L. J., Grucza, R. A. Long-term effects of minimum legal drinking age laws on marijuana and other illicit drug use in adulthood. Drug Alcohol Depend. 2015 Apr 1;149:173-9. doi: 10.1016/j.drugalcdep.2015.01.043. Epub 2015 Feb 10. PMID: 25707705.
Our active projects include:
Pharmacoepidemiology of medication assisted treatment (MAT)
Under-utilization of evidence-based treatment for opioid use disorders is a serious concern in Medicine and Public Health. The problem is particularly serious for adolescents and young adults. Our goal is to quantify this treatment disparity and to use administrative data to examine whether the apparent effectiveness and cost-effectiveness of MAT is similar in adolescents and young adults compared to older adults.
The role of smoking in suicide risk
While it is traditionally believed that smoking is a correlate, but not a contributing cause for suicide and mental illness, evidence is mounting that smoking may contribute to worsening mental health and therefore to suicide risk. We are using tobacco control policy change as a natural experiment to help disentangle this relationship.
Cannabis use and suicidal behaviors
Many investigators believe that cannabis can contribute to poor mental health and possibly suicide risk among vulnerable individuals, but the magnitude of any such effect is debated. We are examining whether medical or recreational legalization of cannabis has led to increases in clinically significant suicide attempts and related mental health outcomes. We are also exploring other consequences–both negative and positive–of cannabis policy liberalization.
Trends in adolescent health risk behaviors
Downward trends in juvenile delinquency, use of most drugs, binge drinking and other behaviors have been noted by numerous investigators, but no systematic research has asked if these trends are related. We hypothesize that there has been a marked decline in “Externalizing” — a hypothesized trait correlated with propensity for adolescents to engage in multiple risk behaviors. A pending grant proposal will test this hypothesis and begin to explore possible causes for this trend.
An Examination of Age-Related Disparities in Medication Assisted Treatment and Associated Outcomes (for Opioid Use Disorders)
My role: Principal Investigator
Smoking, Suicide and Mental Health: Using Policy Change to Probe Causality
My role: Principal Investigator
Cannabis, Depression and Suicidal Thoughts and Behaviors
My Role: Co-Principal Investigator