How poverty and addiction intersect in the U.S.

It is often said that addiction doesn’t discriminate. Data from numerous sources informs us that addiction can affect anyone, regardless of their class, gender, race, or occupation. While this sentiment may be true, it’s also clear that addressing addiction is far more difficult when you’re poor.

Perhaps the greatest example of this lies in observing conditions in the United States, where income inequality is rampant and addiction has been declared a public health crisis. States across the country are particularly concerned about an emerging opioid crisis, and a lack of infrastructure to help those most affected. Instead, criminalizing illicit activity remains the default, despite evidence that suggests that criminalization simply doesn’t work.

The crisis has been caused by several factors, and while doctors and pharmaceutical companies are working together with Federal lawmakers, drug enforcement, and recovery programs to mitigate them, the number of individuals struggling with addiction continue to rise.

So how does this opioid crisis — a crisis that does not discriminate by ethnicity, gender, sexual orientation, or economic status — intersect with poverty? To truly understand and address the nature of this public health crisis, it is necessary to understand the cycle of poverty and how socioeconomic challenges can prevent an individual from overcoming addiction.

First, it’s important to understand that there is historical precedence to this issue. After all, this epidemic isn’t new. In the late 1980s and early 1990s, America faced a similar crisis when addiction to crack cocaine rose to prominence in Black communities. At the time, this community was facing high rates of unemployment, due in part to a decline in manufacturing jobs and their racially discriminatory hiring and firing practices.

Today, many Americans find themselves facing similar sets of extenuating circumstances.

“White America today looks economically a lot more like Black America in the 1990s: stable well-paying jobs are disappearing, replaced by lower-wage positions with far more uncertainty,” writes The Guardian’s Maia Szalavitz. “Criminalizing drug use, while proven not to work, remains the default.”

It’s these socioeconomic challenges that make overcoming addiction difficult, and only add to the public health crisis that has emerged since then.

“Though advocates like to claim that addiction is an equal opportunity destroyer,” Szalavitz continues, “in reality, it is far less likely to hit people who have stable, structured lives and decent employment than it is those whose lives are marked by uncertainty and lack of work.”

When the economy is stable, the middle class is flourishing, and economic inequality is addressed, addiction rates typically decline. But when unemployment rates rise, the job market is unstable, and income inequality is prevalent, more people find themselves at risk for drug addiction and their chances of overcoming these obstacles drastically declines. Given the nature of cyclical poverty, this is even more true, and there is abundant data to prove it.

According to research by the Centers for Disease Control and Prevention, heroin addiction is three times as common among individuals who make less than $20,000 per year when compared to populations that make ovr $50,000 per year. The study also notes that those who have obtained a higher educational status are less likely to become or succumb to addiction.

Furthermore, research indicates that those who live in socioeconomically balanced societies are far less likely to use and abuse drugs and other harmful substances. Societies like the U.S. and the UK, where there are large discrepancies between the wealthy and impoverished have much higher rates of drug and alcohol abuse.

In addition, there is a large pool of data that suggests that addiction rate among those who are unemployed are twice as high when compared to individuals who have jobs. While some may argue that this indicates that addiction was the reason for job loss, research actually confirms that in many cases unemployment tends to predate addiction.

Regardless of the timeline in which addiction occurs, it’s clear that access to a stable income is important, and those without gainful employment have a far more difficult time accessing treatment from mental healthcare professionals.

When decent jobs are available and people have access to a living wage, recovery from addiction becomes far more accessible.

If the U.S. truly wants to help individuals suffering from addictions, policy makers and healthcare leaders will have to look more closely at what drives people to abuse substances in the first place. Although the reasons for this are plentiful, it’s clear that wealth and income inequality cannot be ignored any longer.