How Have Socioeconomic Factors Played a Role in the Addiction Crisis?

In my years as an addiction counselor, one thing I’ve learned is that while addiction does not see color, the ethnicity, age, gender, income level, background and geographic location of the addict can certainly affect their access to care and ultimately the outcome of treatment. I’ve spoken with thousands of addicts from all backgrounds, from all ages, and from all demographics. Each one had their own unique struggles, but the underlying factors of their crisis were similar, one to the next. Addiction is addiction. It can affect anyone. But there are socioeconomic factors which play a rule. In fact, socioeconomic factors result in minorities being more heavily affected by drug addiction than other demographic groups. It's not a race issue, it’s a socioeconomic disparity which creates the appearance of a race issue.

So why then, do we blame certain demographics for being more likely to be drug users? Why do we assume that certain unfortunate common denominators in drug use among various demographics have to do with the color of their skin? Too many times I have seen ignorance in this area turn into racism, and that gets us nowhere.

Explaining Addiction and Race—An Exploration of Sociocultural Theory

To say that one racial demographic is more prone to using drugs than another because of their race is merely a racist comment. And to foster that viewpoint is to further the cesspool of addiction among minorities. It makes it worse for all of us. It will take us zero steps forward plus two steps back. Let’s explore some information that could show us a real path out of this problem.

Racist Comments Persist

I can’t help but remember the comment from Kansas State Representative Steve Alford, who in January 2018 talked about the 1930s marijuana prohibition, using race as an argument for continued prohibition. He said, “What was the reason they did that? (marijuana prohibition). One of the reasons why—I hate to say it—is the African Americans, they were basically users, and they responded the worst off to those drugs. It’s because of their character makeup—their genetics and that. And so basically what we’re trying to do, is we’re trying to do a complete reverse of the people not remembering what’s happened in the past.”

But we can explain different drug-use trends in different socioeconomic demographics. And it has absolutely nothing to do with genetics or “character makeup.” It is an issue of socioeconimic backgrounds, not of race. There is a purely scientific explanation for this phenomenon. Maybe if Representative Alford had the data I’m about to share with you, he wouldn’t have made such distasteful comments spoken out of ignorance.

How Humans Learn

The 1920s brought us a lot of things, one of which was Sociocultural Theory. The concept of sociocultural theory plays into addiction theory significantly, especially as pertains to addiction and socioeconomic condition.

According to sociocultural theory, parents, guardians, caregivers, educators, peers, and the culture, in general, are highly responsible for the learning and cognitive development of their youth. Sociocultural Theory takes the position that much of our learning process is based on our interactions with others, more so even than our actual education and individual learning processes. Essentially, we become who we are around.

So how does all of this relate to addiction and one’s socioeconomic condition? Let’s examine the cyclic effect of addiction and drug use in the demographics of those who are less privileged, those who are at a socioeconomic disadvantage. This is an ongoing crisis, one which spans decades or centuries. Certain minority groups seem to always struggle with the same types of addiction problems, even several generations apart. And yet these same minority groups also always happen to be at a serious socioeconomic disadvantage.

Sociocultural Theory and Minority Drug Use Trends

Sociocultural Theory is a good explanation for why some demographics tend to fall prey to addictions to certain substances. If our societal upbringings and our cultural background weighs so heavily on our education and learning process, this has the potential to have good effects or poor ones. Take the African American community, for example, a community that was absolutely eviscerated by the crack cocaine epidemic of the 1980s (and which is still struggling with cocaine and crack cocaine problems today).

Wouldn’t it be possible that, if young African Americans were growing up in communities where crack cocaine was the predominant drug of choice, that such youth would learn (through societal exposure) that using crack cocaine was the “answer to coping with oppression and life’s many struggles?”

This is a cultural and generational “passing on” of trends. If dad used cocaine as a coping method, his son is likely to do the same because the son grew up learning that cocaine was a “problem-solving method” that dad used to cope with the struggles of being part of an underprivileged racial minority.

We see the same trend in Native American cultures. We all know the story of the sheer devastation that was the white man’s influence with alcohol on the Native Americans in frontier America circa 1600-1800. Such a cultural change was extremely detrimental for the Native Americans, who were strangers to immoderate alcohol consumption. Europeans did not introduce alcohol to the Natives (a common myth), but they did introduce belligerent over-drinking to Native culture. Fast forward 200 years and Native Americans still struggle with statistically higher alcohol-misuse statistics. Societal and cultural exposure to alcoholism among Native youth indoctrinates them that alcohol consumption is a method of problem-solving for difficult times.

We see a similar trend in poor white neighborhoods. HealthDay reports that poor white Americans bear the brunt of the opioid epidemic. According to that research, poor white neighborhoods suffer opioid overdose deaths at a rate of 9.6 deaths per 100,000 population, as compared to 3.7 deaths per 100,000 population in non-white poor neighborhoods.

How Can We Use This Information?

The sheer buffoonery that the human race is capable of when it doesn’t have the correct information never ceases to amaze me. When confronted with African American minorities (who have a higher prevalence of crack cocaine use than whites), what do we do? We incarcerate them at a mad rate. We don’t help them. We adopt this underlying, false, and very racist idea that “That’s just what black people do.” And since we “don’t know how to help them,” we stick them in jail, because that’s what we do in America with people who we don’t know how to help. It’s either that or mental hospitals. From the Prison Policy Initiative, the U.S. incarcerates just under 2.3 million people. Such individuals are detained among 1,719 state prisons, 102 federal prisons, 1,852 juvenile correctional facilities, 3,163 local jails, and 80 Indian Country jails. Then there’s also the military prisons, immigration detention facilities, civil commitment centers, state psychiatric hospitals, and prisons in the U.S. territories.

The disparity in incarceration is unacceptable. African Americans are incarcerated at five times the rate of whites. Consider this quote from the National Association for the Advancement of Colored People, “In the 2015 National Survey on Drug Use and Health, about 17 million whites and 4 million African Americans reported having used an illicit drug within the last month. African Americans and whites use drugs at similar rates, but the imprisonment rate of African Americans for drug charges is almost 6 times that of whites.”

Rather than blatantly incarcerating minorities and the socioeconomically disadvantaged for having substance abuse problems, we need to recognize that drug-use trends among such demographics is not a product of some flaw in that minority group, but it is instead the result of generations of shared addiction struggles within that demographic. If we could tap into the wealth of knowledge found in sociocultural theory and if we could apply that data within addiction treatment, we could perhaps reverse the unique substance abuse trends that such minorities face.

Freeing demographically defined populations from drug problems that have haunted them for generations is a worthwhile endeavor. Let’s help everyone overcome drug and alcohol addiction. The alternative (incarceration) isn’t helping anyone.

Sources:

• https://www.independent.co.uk/news/world/americas/marijuana-legalisation-racist-argument-kansas-republican-steve-alford-african-americans-genetics.html
• https://www.verywellmind.com/what-is-sociocultural-theory
• http://www.ceebl.manchester.ac.uk/events/archive/
• https://www.ncbi.nlm.nih.gov/pmc/articles/
• https://www.prisonpolicy.org/reports/pie2018.html
• https://www.naacp.org/criminal-justice-fact-sheet/
• https://consumer.healthday.com/mental-health-information-25/addiction-news-6/poor-whites-bear-the-brunt-of-u-s-opioid-crisis-studies-find.html

Reviewed and edited Claire Pinelli ICAADC, CCS, LADC, RAS, MCAP