Socioeconomic status and addiction
Socioeconomic status (SES) refers to an individual's social standing, which is influenced by factors such as income, education, occupation, and community. This classification is often divided into high, middle, and low categories. Addiction and substance abuse occur across all socioeconomic groups, though the dynamics can differ significantly. Individuals with low SES may face challenges such as lower income, unemployment, and limited educational opportunities, which can lead to increased stress, anxiety, and depression. These mental health issues may drive some individuals to substance abuse as a coping mechanism, creating a cycle where addiction further entrenches them in poverty.
Conversely, individuals in middle and high SES categories can also struggle with addiction, often due to social and emotional pressures, albeit their substance use may be less visible. Teenagers in these groups are especially vulnerable, with greater access to expensive substances and fewer parental controls. While research has shown addiction occurs across all SES levels, the factors contributing to substance abuse can vary, necessitating tailored approaches for prevention and treatment. Effective interventions should consider the broader community context and involve educational programs aimed at both individuals and families, addressing the root causes of addiction to foster a healthier society.
Socioeconomic status and addiction
DEFINITION: Socioeconomic status is the social classification of an individual by such measures as income, education level, occupation, and community of residence. Socioeconomic status is often subdivided into high, middle, and low categories. Addiction and substance abuse affect persons of all socioeconomic stratifications.
Low Socioeconomic Status
When compared with persons of middle or high socioeconomic class, persons with a low socioeconomic status have lower salaries and accumulated wealth, may be unemployed, may have lower levels of education (often because of dropping out of school), and may face homelessness or the prospect of losing their current place of residence. These stressors may lead to depression and anxiety.
In general, an individual with depression is more likely to abuse substances to ease these feelings. Addiction, however, often perpetuates one’s lower socioeconomic status because smoking, alcohol, and drug use all cost money; furthermore, abusing substances takes time from potential employment or from seeking employment. To maintain the addiction or substance abuse, the person may undertake illegal activities, such as dealing drugs, sex work, or stealing to pay for or obtain a substance.
A person with low socioeconomic status often resides in a neighborhood that may have higher risk factors for substance abuse and addiction. These risk factors include the ready availability of drugs, the prominence of successful drug dealers as role models or leaders in the neighborhood, and a lack of educational opportunities in areas without adequate funding resources. Homelessness also is included in this category. However, a common misconception is that addiction causes homelessness, but more often, the reverse is true: Addiction is often a result of homelessness, which increases feelings of hopelessness and depression.
It is well-documented that an addiction to smoking, alcohol, or drugs can lead to significant health concerns. Persons of lower socioeconomic status have limited and unequal access to healthcare. While the Affordable Care Act (ACA) improved healthcare access, including treatment for substance use disorders, millions of Americans still lacked health insurance through the 2020s. Untreated medical problems contribute to feelings of stress and depression and can, therefore, perpetuate addiction. Additionally, without access to care, individuals may self-medicate with illicit substances, which can become a severe addiction. Some studies have found the lower one’s socioeconomic status, the greater that person’s risk of dying from complications of alcohol or drug abuse.
Individuals in low-income communities smoke cigarettes more often and for more years than individuals in higher-income communities. A nicotine addiction is expensive. Some data indicates that individuals who smoke a pack each day may spend up to 25 percent of their annual income on cigarettes. In general, income and spending on cigarettes have an inverse relationship—a cigarette user's average income expenditure on tobacco products increases as an individual's income decreases.
Lower educational levels also are associated with substance abuse. Some studies have found that the lower the person’s educational level, the more likely that person will drink more alcohol per occasion. Other studies have found that whereas cocaine use is on the decline in persons of higher socioeconomic status, use in persons of lower socioeconomic status remains constant. This difference has been attributed to successful education programs in schools and communities regarding the health hazards of cocaine use.
Addiction also may create feelings of stigmatization and discrimination. For example, low-income or unemployed people are stigmatized by society; addiction might stem from this stigma or enable it.
It is important to remember that while the variables mentioned here are risk factors for substance abuse, not all studies have documented that persons from low socioeconomic status groups have different addiction rates from persons of middle or high socioeconomic status groups. Some studies show that parenting skills and parental psychopathology play more of a role in the development of addiction than does socioeconomic status. There are many factors that lead to drug and alcohol abuse, and continuing research is necessary to understand the contributions of these risk factors in addiction.
Middle and High Socioeconomic Status
Early research on risk factors for substance abuse focused solely on persons from low socioeconomic backgrounds because of stereotypes and misconceptions. However, later research indicates that substance abuse occurs among persons of all socioeconomic statuses. Although depression and anxiety within the low socioeconomic status group may stem directly from financial and educational stressors, no person is immune to these psychological diagnoses.
Persons of middle and high socioeconomic status experience social and emotional stresses too, but perhaps for different reasons. These stresses include the demands of a job, family, and school. Often, a person’s addiction is concealed at the place of employment or at home, leading to feelings of guilt and shame. Among persons in the middle and high socioeconomic status groups, teenagers are at greatest risk for substance abuse and addiction.
Typically, persons of middle and high socioeconomic status do not initially have the same financial pressures of addiction because, by definition, they begin with a greater individual or household income. Thus, money is available to support not only an addiction but also a more expensive addiction. Though research has demonstrated a higher rate of nicotine addiction in lower socioeconomic status groups, it has found an increased risk for alcohol, marijuana, and cocaine abuse in middle and high socioeconomic status groups. Teenagers who are experimenting with drugs have a greater ability to buy more expensive substances and in greater quantities.
Persons of middle and high socioeconomic status have more access to educational resources. As parents have typically obtained a college or higher degree, they encourage children to do the same. A teenage child who lives independently from their family at college has a greater risk for substance abuse because of this freedom from parental oversight. However, the younger the addiction begins, the more likely a person will not complete their education and obtain a job. This person also is more likely to be prosecuted for using illegal substances.
When an addiction becomes apparent within the wealthier family, more resources are often available for disease intervention and management. These families tend to have greater access to expensive in-patient treatment facilities, or they are more likely to be able to financially support the individual while in treatment or when facing criminal charges.
Family mobility, defined as families moving into and out of a community, also may play a role in addiction. Increased family mobility decreases the sense of community and social interaction within a neighborhood. Persons who cannot rely on established bonds within their community are at a greater risk for substance abuse and addiction.
Prevention and Treatment
The challenge with treating and preventing addiction in all socioeconomic classes stems from the need to address a multitude of variables, including all of the aforementioned components of socioeconomic status and the family system. The process must start with treating any underlying psychological diagnoses, such as depression or anxiety, with specific attention to the reason for these feelings. This treatment may involve psychotherapy alone, but it also may be combined with pharmacotherapy if needed.
For persons of low socioeconomic status, vital to goal achievement are programs that help them obtain better jobs or receive higher education. The necessary tools or knowledge to help realize these goals may not be available, however.
It is extremely important for governmental programs to target not just one person with an addiction but the larger community too. Children and young adults often will succumb to peer pressure, and only when the entire community, including the family unit, helps to reduce the risk factors for addiction will neighborhood programs truly succeed. This approach also benefits societal goals for greater overall productivity and less energy use for prosecuting individuals with addictions and treating substance use disorders.
Teenagers are considered to be at the highest risk within the middle and high socioeconomic status groups, so interventions should target this population. Adolescents are at risk for continuing the addiction into adulthood. School and governmental programs can educate not only the teenager but also the parents, other family members, and educators. Also, parents should closely monitor and regulate their child’s monetary allowances, which can be used to buy substances of abuse.
Bibliography
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