Economic Status and Abuse

Economic status refers to the bracket or class a person or household falls into based on their income production level. In 2012, around 122,459,000 households had income during the year, and 4.5 percent of them brought in more than $200,000.^[1] Those who made between $39,736 and $104,087 that year were considered to be of middle class socioeconomic status.^[2]

Stereotypes

Addiction occurs in various environments and affects different types of people from wide-ranging walks of life. How then does the stereotype exist that all addicts are poor, unemployed, homeless and uneducated? Elaborating further on that theory, many people naturally assume addiction itself is a disease that only impacts the weak-willed or lazy.

The 23.1 million people who are dependent on drugs and alcohol paint a different picture though.^[3]

What Really Causes Addiction?

How wealthy you are has very little to do with your propensity toward addiction. The reason that these stereotypes form is because substance abuse is in fact more common among individuals living in poverty or of lower economic status; however, the two aren’t directly linked, and this doesn’t show cause and effect.

Instead, substance abuse is more of a byproduct of the lifestyle led by people of limited financial means. The indirect link is usually spread across many contributing risk factors, not just one sole cause. For example, a neglectful mother who is out of work and living in government housing with her child may pass on her tendencies toward drowning her sorrows in alcohol every day. This is both genetic and environmental influence.

Some common associated links between economic status and substance abuse are:

Education
Abuse and neglect
Genetics
Mental health
Race
Parental substance abuse
Poverty versus wealth

It isn’t that a wealthy person couldn’t experience these same traumas; it is that they are merely less likely to occur in households that aren’t in poverty. In essence, the risk factors that predispose people to substance abuse and addiction are more prevalent in lower economic areas and families than in others.

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Education

Level of education is strongly linked to substance abuse tendencies.

In a nutshell, those with higher educations are less likely to be substance abusers. What does this mean for those who can’t afford an education beyond high school? A survey comparing high school seniors from 1981 and 1986 showed declining rates of substance abuse during the five-year period; however, the most significant decline was among students who had more educated parents — decreasing from 36.7 percent to 23.7 percent. Furthermore, the least significant change was among students whose parents did not attend high school — a mere 2.7 percent decrease from 25.4 percent to 22.7 percent.^[4]

Abuse and Neglect

We’ve known for some time now that a history of abuse and neglect are risk factors for substance abuse later in life. Among reported cases of childhood abuse and neglect over a 10-year period, over 70 percent of them involved drug or alcohol abuse.^[5] Adult substance abusers are 2.7 times more likely to be abusive toward their children and 4.2 times more likely to be neglectful.^[6] What we also know is that this same history is more likely to occur in lower income households.

While the two separate incidences do not show direct causation, it is compelling enough evidence to consider the association between both abuse/neglect and low income/poverty as precursors to addiction. In fact, both combined may even further put someone at a predisposal for drug or alcohol abuse. In a survey of state welfare offices, 85 percent claimed parental drug and/or alcohol use and poverty were the top two problems in their child protective cases.^[7]

DNA

Genetics play just as strong of a role as environment does when it comes to substance abuse. Genetics are responsible for around 40 to 60 percent of the predisposition an addict carries toward substance abuse.^[8] However, do genetics have any influence on economic status? There are surely exceptions to the rule, but most of the time, wealth breeds wealth, and this may be linked to education, with higher-income families being more likely to have children who attend college.

One study shows that high SAT scores are generally correlated with higher household incomes across the board.^[9]

Mental Illness

Mental health is one of the biggest risk factors documented for substance abuse. Approximately 29 percent of all people diagnosed with a mental health disorder also abuse drugs or alcohol.^[10] Considering mental illness affects 43.7 million Americans, that’s a lot of people dealing with co-occurring issues.^[11] Likewise, mental illness isn’t selective in whom it chooses. There are plenty of wealthy people who are diagnosed with bipolar disorder, depression and other mental health issues. Again, however, the likelihood of many of these illnesses is higher among those of a lower economic status.

Severe mental illness is most common – at 16.3 percent – among those with family income levels of less than $20,000.

The lowest instances of severe mental illness – at 6.4 percent – occur in those with high family income levels of $75,000 or more.^[12] The link isn’t any clearer with mental illness than anything else we’ve discussed here, but it is obvious that economic status can influence risks toward mental health, which can influence the risk toward substance abuse. It’s a slippery slope of cause and effect. Another study showed a tendency for poverty to actually occur prior to the development of mental illness, except where schizophrenia was concerned.^[13]

Race

In today’s world, there is still a stark imbalance among races and wealth. The median income for Caucasian households in 2009 was $51,861; for African American households, it was $32,584; and for Hispanic households, it was $38,039.^[14]

Substance use and abuse are more common among Caucasians than African Americans. A study of 72,561 youths resulted in 37 percent of them engaging in substance use, nine percent of which were white, compared to five percent being black.^[15]

Mental illness is a more minor factor here as the rate of occurrence among races doesn’t seem to differ significantly. In the US alone, 33.3 percent of white people, 35.5 percent of black people, and 34.4 percent of Hispanics account for self-reported cases of poor mental health.^[16]

Parental Drug and Alcohol Abuse

Parental substance abuse during the childhood years can predispose individuals to a host of problems, with adult drug and alcohol abuse being one of them. Children of alcoholic parents have a fourfold increased risk of being dependent on alcohol themselves later in life.^[17] In addition, households in which one or both caretakers are substance abusers are more likely to be of lower economic status.

Recent research shows about nine percent of all American children live with at least one parent who abuses drugs or alcohol.^[18].

Poverty vs. Wealth

Overall, substance abuse is more prevalent among families living in poverty, as are most of the risk factors for drug and alcohol abuse listed above. Around 20 percent of people on welfare in America reported using some kind of illicit drug in the year prior to being surveyed.^[19] Someone who makes less than $20,000 annually is about one-third less likely to recover from a cocaine addiction than someone who makes over $70,000.^[20] Even employment has a discernable effect on the likelihood of substance abuse. A 2007 survey notes that 23 percent of unemployed persons had used cocaine at least once, while 19 percent of those employed full-time and almost 15 percent of part-time employees had tried it.^[21]

Substance abuse and homelessness often co-occur. Data from 2003 estimates 38 percent of the homeless population were alcoholics and 26 percent were drug abusers.^[22] Frequently, homelessness is a result of substance abuse. Still, many who are without a place to live turn to drugs and alcohol to avoid dealing with their feelings and life problems.

Mental illness is often a factor for the homeless. A 2010 report notes 34.7 percent of homeless people in shelters as having a chronic substance abuse problem, and 26.2 percent of the same population had a severe mental health disorder.^[23]

Poverty is a factor in the likelihood of kids trying drugs and alcohol. That being said, some reports attest to children in poverty-level households being more likely to smoke cigarettes but less likely than their wealthier counterparts to binge drink.^[24]

Getting Help

There is a great divide between the quality and efficacy of treatment options available to addicts of different economic statuses. To date, there is no real regulation on the amount that a substance abuse treatment facility can charge for their services.

In fact, 37.3 percent of those who didn’t get the treatment they needed for a substance abuse problem in 2011 claimed they didn’t due to an inability to pay for it or due to a lack of health insurance coverage — the most commonly cited reason for foregoing rehab.^[25]

For the minimum wage worker, unemployed person, or homeless individual, a high level of treatment will never be a realistic option for them. Instead, they must settle for less, sometimes even what state-funded assistance can supply them with.

Does a higher price tag automatically equate to better care? Surely not across the board, but there are always exceptions. One facility may charge four times as much as another and have half the success rate that the cheaper institution does. The point is that addicts with some wealth have more options altogether. Often, people have no choice but to go with whatever is cheapest, regardless of the research backing up success rates or treatment plans. This can be quite disheartening for addicts who are in need of certain types of treatment that no facility in their price range offers.

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Citations

[1] Elwell, C.K. (2014 Mar 10). “The Distribution of Household Income and the Middle Class.” Federation of American Scientists. Accessed June 3, 2015.

[2] Ibid.

[3] “Number of People Seeking Addiction Treatment Could Double Under New Health Law.” (2013 Sep 12). Partnership for Drug-Free Kids. Accessed June 3, 2015.

[4] Kerr, P. (1987 Aug 30). “Rich vs. Poor: Drug Patterns are Diverging.” New York Times. Accessed June 3, 2015.

[5] “Substance Abuse Treatment for Persons with Child Abuse and Neglect Issues.” (2000). Treatment Improvement Protocol. Accessed June 3, 2015.

[6] Ibid.

[7] “The Impact of Substance Abuse on the Child Welfare System.” (n.d.). Florida Alcohol and Drug Abuse Association. Accessed June 3, 2015.

[8] “Addiction Science: From Molecules to Managed Care.” (July 2008). National Institute on Drug Abuse. Accessed June 3, 2015.

[9] Clarke, C. (2009 Aug 28). “Why Rich Parents Raise Smarter Children.” The Atlantic. Accessed June 3, 2015.

[10] “Substance Abuse and Mental Health.” (n.d.). Helpguide. Accessed June 3, 2015.

[11] “Mental Health by the Numbers.” (n.d.). National Alliance on Mental Illness. Accessed June 3, 2015.

[12] “Mental Illness and Poverty: A Fact Sheet.” (n.d.). Florida Council for Community Mental Health. Accessed June 3, 2015.

[13] Grohol, J.M. (n.d.). “The Vicious Cycle of Poverty and Mental Health.” Psych Central. Accessed June 3, 2015.

[14] “Money Income of Households—Percent Distribution by Income Level, Race, and Hispanic Origin, in Constant (2009) Dollars: 1990 to 2009.” (n.d.). United States Census Bureau. Accessed June 3, 2015.

[15] Szalavtia, M. (2011 Nov 7). “Study: Whites More Likely to Abuse Drugs than Blacks.” TIME Magazine. Accessed June 3, 2015.

[16] “Percentage of Adults Reporting Poor Mental Health by Race/Ethnicity.” (n.d.). Kaiser Family Foundation. Accessed June 3, 2015.

[17] “Children of Alcoholics: A Guide to Community Action.” (n.d.). Substance Abuse and Mental Health Services Administration. Accessed June 3, 2015.

[18] Capaldi, L. (2008 May 1). “The Relationship Between Parental Substance Abuse and the Effects on Young Children.” Providence College. Accessed June 3, 2015.

[19] Pollack, H.A., “Substance Abuse Trends among Welfare Recipients.” (n.d.). Substance Abuse Policy Research Program. Accessed June 3, 2015.

[20] Szalavitz, M. (2011 Nov 1). “Yes, Addiction Does Discriminate.” The Fix. Accessed June 3, 2015.

[21] Gardner Selby, W. (2012 Nov 26). “Joe Deshotel says there is no evidence showing poor people use drugs more frequently than members of other socioeconomic groups.” Politicfact Texas. Accessed June 3, 2015.

[22] “Substance Abuse and Homelessness.” (July 2009). National Coalition for the Homeless. Accessed June 3, 2015.

[23] “Current Statistics on the Prevalence and Characteristics of People Experiencing Homelessness in the United States.” (July 2011). Substance Abuse and Mental Health Services Administration. Accessed June 3, 2015.

[24] “Childhood economic status affects substance abuse among young adults.” (n.d.). Duke Medicine. Accessed June 3, 2015.

[25] “Health Insurance Status of Adult Substance Abuse Treatment Admissions Aged 26 or Older: 2011.” (2011). Substance Abuse and Mental Health Services Administration. Accessed June 3, 2015.