Editor’s Note: This is part four in a five-part series on a new approach to the War on Drugs. This is a nuanced topic and we present the views here as a contribution to the conversation. You can read Part I here and Part II here and Part III here.
Research shows that unemployment and low socioeconomic status are linked with higher risk for addiction, compared to having a job and being in the middle class. Although the media has focused on heroin and prescription opioid misuse these days as being a “middle class” problem, the risk of addiction is more than three times higher for people making less than $20,000 compared to those who make over $50,000. These facts make President Trump’s promises to increase employment — perhaps through an infrastructure program — critical if he wants to deal with the opioid epidemic in the long run.
Meaningful work is one of the best antidotes against addiction: employment is a key factor predicting who will avoid addiction, or will struggle with addiction for a short period of time and eventually recover.
This correlation runs both directions: people with addiction lose their jobs as a result of their impairment. Being hopeless and jobless makes escaping with drugs more attractive. The research shows that addiction does lead to some cases of unemployment — but also, unemployment itself increases drug use. For people to sustain recovery, having a job matters.
These links can be seen clearly in a recent analysis done by the Federal Reserve Bank of St. Louis, which looked at how the increase in unemployment due to the Great Recession was accompanied by a rise of drug use by the unemployed. Although some of this could have resulted from methodological issues, the size of the increase suggests that unemployment, which is a source of stress, does put people at higher risk for drug problems.
Common sense suggests some reasons for these associations: employment is not only how many of us spend most of our time, it’s also a source of meaning, purpose and identity. Escaping pain becomes desirable when people feel hopeless, lost and unable to find a role for themselves. Addiction results.
To fight addiction in the long run, we need a large, healthy middle class. Without a middle class, even the best prevention and treatment programs cannot sustain health. The allure of drugs are too great as they kill both physical and emotional pain.
A healthy, well-employed middle class is also a hedge against drug dealing and related crime. Both the opioid and crack epidemics provided oblivion for customers while providing income and (illegal) employment for dealers.
Where there is despair and hopelessness, there will be drugs, dealers, and chaos. No attempt to fight supply will succeed if people don’t have alternative sources of pleasure and purpose. If Donald Trump can understand this and create policies that recognize the nature of addiction, we’ll not only dramatically reduce the overdose death toll, but we might actually start to create a culture that can take advantage of the talents and productivity we now waste by simply incarcerating people with addiction, rather than preventing or treating it.