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Tuesday, December 11, 2018  Spokane, Washington  Est. May 19, 1883
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Ask Mr. Dad: The connection between income and addiction: It may not be what you think

Dear Mr. Dad: The high schools in our old neighborhood were well known for drug and alcohol problems. For that reason, a few months ago, my family moved to a new (and very expensive neighborhood), so that my son could attend one of the best schools in our state, one that we hoped wouldn’t have those problems. My husband and I place a high value on education, but from what I’ve been hearing, things may be even worse at this top-rated school. Did we just get unlucky or is this a national issue?

A: Unfortunately, it’s a national one.

A lot of us fall for the stereotype that poor people are more likely to use drugs and alcohol than wealthier people. The thinking is that poor people are self-medicating to cope with the stresses associated with poverty, or they don’t have enough information about the dangers of drugs and alcohol to make smarter decisions. The truth, as you’ve discovered, is much more complex, with different income groups abusing different substances and for different reasons.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 35 percent of adults living in homeless shelters have substance abuse problems. No one knows what the percentages are for homeless people living on the street, but I’m sure it’s even higher. For one drug in particular, heroin, those making less than $20,000/year are more than three times more likely to be users than those making more than $50,000/year, according to the most recent data from the Centers for Disease Control and Prevention (CDC). Overall, the rate of overdose deaths from prescription opioids (hydrocodone, oxycodone, etc.) are highest in counties with the highest poverty rates. So yes, poor people may be more likely to use some drugs.

Alcohol use, however, is far more common among more affluent people. A recent Gallup poll found that 78 percent of people making more than $75,000 per year drink alcohol, compared to 45 percent of those making less than $30,000 per year. Those with more education are also more likely to drink: more than 80 percent of college grads say they do vs. just more than half of those with a high-school education (or less). And employed people are more likely to drink than the unemployed. While alcohol and opioids directly kill about the same number of people every year (more than 30,000), when you include car accidents, murders and other drug- or alcohol-related deaths, alcohol kills far more people.

Adolescents’ likelihood to use drugs or alcohol are affected by their parents’ income and education levels, but it’s not consistent. For example, kids whose parents have the least education are the most likely to abuse drugs. But high-schoolers whose parents are affluent and/or highly educated are much more likely to drink and use marijuana.

The place where income plays the biggest role is in treatment. Nearly half of those who enter rehab or other substance-abuse programs have insurance, which picks up most of the cost. A majority of the rest pay out of pocket. People with less education are less likely to have jobs, so they’re less likely to have insurance or extra cash to pay the bills. And although poor people may be able to get some assistance under the Affordable Care Act, they’re at a distinct disadvantage.

As we’ve seen, there’s a connection between income and substance abuse. But that’s just one of many factors. The biggest one of all is sex. Across all races, ages, education levels, and income levels, males are far more likely than females to abuse – and die from – drugs and alcohol. There are numerous programs out there trying to battle our epidemic of substance abuse by targeting race and income. But in my view, any programs that don’t deal head-on with the issues that drive boys and men are destined to fail.


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