The Addicted Poor

There is an unclear relationship between addiction and poverty. Addiction can cause poverty, but poverty can also create addiction. Addiction is somewhat higher among the poor in the city, but not by much, whereas Republicans are absolutely certain that addiction is entirely a problem of inner city blacks, who also refuse to work.

Charles Blow’s column in the 22 Mar 14 NYT lambasts Senator Paul Ryan’s dog-whistle racism from a recent interview that affirms this right wing belief, in spite of Ryan’s protestations. Blow quotes professor Mark R. Rank: “Few topics in American society have more myths and stereotypes surrounding them than poverty, misconceptions that distort both our politics and our domestic policy making. They include the notion that poverty affects a relatively small number of Americans, that the poor are impoverished for years at a time, that most of those in poverty live in inner cities, that too much welfare assistance is provided and that poverty is ultimately a result of not working hard enough. Although pervasive, each assumption is flat-out wrong.” Blow’s figures also show that addiction in the city is not markedly different from the national incidence.

Addiction occurs at all social levels. Alcoholism is well known among the wealthy, and cigarette addiction among blue collar workers. No class and no person is immune.

Addiction can cause poverty,
but poverty can also create addiction.

There are various estimates of the number of addicts in the US, usually in the range of 22-million to 23.5-million, some seven percent of the population, an outrageous number. Of these, only 11% are treated, and 40,000 die each year. Why do so many risk it?

We have been singularly unsuccessful at bringing addiction under control. My opinion is that we waste vast amounts of money on the wrong things. Instead of scolding the addicts, arresting low-level drug dealers, and spending hundreds of millions battling organized criminal suppliers worldwide, we would probably be more successful if we put a lot more effort into making sure that every child in susceptible years understood addiction and what it does to the human body. Just the photos of wasted addicts are powerful deterrents. Graphic microscope slides comparing normal brain with brain injured by cocaine clearly show the loss of brain cells.

Treating addiction as a crime has resulted in world record incarceration rates while doing next to nothing to deal with the problem of addiction. Drying up the drug market would be far easier with a government program that provided free drugs for any addict willing to participate in a program to end his addiction and help him put his life back together. Note, however, that recovery must include a way for the recovering addict to earn a living, and the absence of such an opportunity may have been what turned him to drugs in the first place.

[Addendum: Take a look at this telling graphic that shows a quick history of the drug war and its results.]

Drying up the drug market would be easier
with a government program.

The costs of addiction are enormous. The economic loss is some $524-billion per year, which comes out to about $23,000 per addict, which is greater than annual income for many of them. This is public cost, but the worst loss is humanitarian, the disintegration of friendships, the loss of means of livelihood, public alienation, and the splintering of families. Addicts, having destroyed all human relationships and the ability to hold a job, are often extremely lonely.

There is a chicken-or-egg relationship between poverty and addiction. Certainly, an addict is more likely to become poor as he destroys his social connections and fails to show up for work. His addiction in time makes him unemployable. He quickly burns through all his friends and eventually his family, who lose sympathy after he tries to borrow money numerous times, does them wrong in various ways, and does nothing to recover. He may commit crimes to satisfy his addiction. But addiction is definitely not just a problem of the poor. Read Abraham Verghese’s book, The Tennis Partner, for a heartbreaking true story of a talented doctor who was unable to kick his meth habit.

The costs of addiction are $524-billion
per year, some $23,000 per addict.

The poor are slightly more likely to fall into addiction, although the effect isn’t at all what the common perception says it is. In the US, harmful drugs are easy to buy everywhere, but especially in poor neighborhoods. Supreme Court Justice Sonia Sotomayor, in her book, My Beloved World, speaks of growing up in such a neighborhood, where the druggies were always in the stairwell. Children in all social settings grow up surrounded by drugs, and some percentage of them succumb to temptation, and become addicted, particularly if their parents or friends are seen as tolerant toward drugs. Once addicted, the deck is heavily stacked against a young person.

My belief is that we would do well to abandon most of our worldwide efforts to halt the supply of addictive substances, and shift the many millions saved to assuring that every student in the country becomes very familiar with the consequences of addiction, and to spend lots more money and time treating addiction as the disease it is, not as a criminal offense.

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