The problem of addiction in the U.S. is serious and ongoing. According to the most recent National Survey on Drug Use and Health (NSDUH), 19.7 million people over the age of 12 struggle with one or more substance use disorders (SUD). As we work to support these people, it’s critical to ask questions about what drives drug misuse and how certain factors contribute to its development.
One factor of focus is income.
Is there a correlation between high income and drug misuse or abuse?
In this guide, we’ll examine the relationship between income and drugs to provide a clearer picture of how the two are related.
What Causes Disordered Use of Substances?
SUD is a complex disease that often looks different from person to person. There are several factors that can contribute to the development of SUD. It’s possible to group the individual causes into four categories:
1. Biological Factors
Physiology can have a significant impact on the potential for developing SUD. Much like foods, people have different reactions to intoxicants that can determine whether or not they may develop disordered substance use. Some people simply don’t like the way a drug like oxycodone makes them feel, so they won’t take very much of it if they can help it. Other people find that the euphoria produced by taking a non-therapeutic amount of opioids outweighs the negative side effects like nausea and itchy skin.
Genetics also play a significant role in whether someone will develop SUD. Studies have shown that genetics make up 40 to 60 percent of a person’s risk, explaining why addiction often affects members of the same family.
2. Psychological Factors
Substance use, misuse, and disordered use are harmful behaviors that very frequently have a basis in a person’s psychology. Why would someone continually engage in activity that harms their health and well-being? Because they learn to expect some form of benefit from using the substance.
Many people begin using drugs or alcohol to relieve stress, anxiety, and other negative emotions when they lack productive, life-affirming coping skills. Substance misuse is often a way for people to mitigate the distress caused by the symptoms of mental health conditions like depression and anxiety.
3. Sociocultural Factors
Sociocultural influences can be described as value systems and beliefs shared by a group of people. For most people, the group with the most influence is the family. If an individual grows up around people who regularly use drugs, substance use becomes normalized, making that individual more vulnerable to the patterns of misuse that lead to addiction.
4. Spiritual Factors
On way to descibe spirituality is that it involves a fundamental belief that life has purpose and meaning, whether that purpose and meaning is guided by a religion or by secular influences. When people lack a sense of purpose and meaning in life, they may turn to substance use to fill the void. Prolonged subtsance use can also impair cognitive function and rational decision-making. An individual with a severe SUD may lose the capacity to apply their principles to their behavior, which can result an escalating pattern of use and misuse.
Income and Types of Substance Abuse
There are several stereotypes and misconceptions about how income affects the type of drugs a person uses. It’s common to believe that higher-income individuals use designer drugs or expensive substances like cocaine. However, the most commonly misused drug for high-income individuals is alcohol. A Gallup survey on alcohol use shows people in higher income brackets with more education are more likely to abuse alcohol than others.
Here’s what the survey said:
- Of those who have households with an income of $75,000 or more, 78 percent said they drink.
- Of those who have households with an income between $30,000 and $74,999, 67 percent said they drink.
- Of those who have households with an income of $30,000 or less, 45 percent said they drink.
The same survey asked about alcohol consumption and the level of education completed by each respondent. Here’s what they found:
- Of those who graduated from college, 80 percent said they drink.
- Of those who attended some college, 64 percent said they drink.
- Of those who have a high school diploma or less, 52 percent said they drink.
Alcohol addiction – known as alcohol use disorder (AUD) – can go undetected for longer in people with higher incomes because they can afford to offset many of the physical effects for longer. While many people with AUD develop poor nutrition habits, for example, someone with more money can afford to make up for that in some part by purchasing pre-made healthy meals. This can make it easier for people to ignore their alcohol problem for longer, which often makes it more challenging to accept proper treatment.
Relationship Between Income and Prescription Drugs
The prescription opioid crisis presents another unexpected relationship between economic status and the misuse of drugs. People might assume that misuse of prescription medication is more prevalent among higher income groups, since they may be more likely to be able to afford the cost of seeing a doctor and purchasing prescriptions.
However, the opposite is true. The most opioid prescribing and deaths by opioid-related overdose occur outside of high-income areas. Instead, the affluent are much more likely to misuse stimulants prescribed for conditions like attention-deficit/hyperactivity disorder (ADHD). The overall prevalence of prescriptions for stimulants like Adderall® was 3.8 percent in the highest income areas compared to just 0.6 percent in lower income areas. This difference is thought to be driven by greater access to medical care and the ability to pay to fill prescriptions as well as pay the premium associated with purchasing these medications illicitly.
Income and Heroin Use
One substance that defies economic categorization is heroin. It’s an opioid that can be obtained fairly cheaply and has never been closely associated with affluent populations, aside from rock stars. However, heroin use has been rising steadily among all income brackets as the nation’s opioid crisis continues, blurring the lines of association between economic groups.
Notably, the Centers for Disease Control and Prevention (CDC) states that the greatest increases in heroin use have occurred in groups that have historically had the lowest rates of use, including women, privately insured individuals, and people in higher income brackets.
One of the reasons for this is the opioid crisis. Painkillers and heroin are both opioids, and when people can no longer afford their prescriptions or cannot get a prescription due to tightening prescribing guidelines, they may turn to heroin for its low cost and high potency. Prescription opioids are so expensive that they can a bank account very quickly, and people trying to hide their opioid use may turn to heroin because it is a significantly cheaper way to sustain their opioid use disorder (OUD).
According to the National Institute on Drug Abuse (NIDA):
- An estimated four to six percent of people who misuse a prescription drug transition to using heroin.
- Approximately 80 percent of people who use heroin started by misusing prescription opioids.
It’s clear that drug use has some unexpected correlations to income level, and that those with higher incomes are not immune to substance misuse and substance use disorder.
SUD Among Children of Wealthy Parents
New research shows that by the time upper-middle-class individuals reach the age of 26, they have a lifetime chance of developing SUD or AUD that’s two to three times higher than the national average. The students surveyed came from competitive high schools with a significant number of high-income parents.
The study also found these students had higher rates of getting drunk and using marijuana, and double the national rate for taking prescription stimulants and cocaine. By age 22, 11 to 16 percent of women and 19 to 27 percent of men developed SUD or AUD. By age 26, the prevalence grew to 19 to 24 percent of women and 23 to 40 percent of men. That’s three times the national average for women, and twice the average for men.
Researchers suggested that affluent adolescents have the money to experiment with drugs and alcohol, such as by obtaining fake IDs. Their parents may believe the experimentation is just a phase, but the outcome of the research shows many of these young adults do not grow out of their substance use habits as adults.
One element suggested as a cause for this trend is highly competitive academic environments. The pressure can cause kids to release stress by using substances. Some of these teens maintain acceptable grades while simultaneously misusing alcohol drugs. Their good-enough grades may cause parents to be more lenient in addressing substance use and misuse.
Another element may be adolescents seeing and replicating substance use behaviors from their parents. However, more research is required to deepen our understanding of how wealth affects the substance use of teens and young adults.
What Causes High-Income Professionals to Abuse Drugs and Alcohol?
At first, it may not be obvious why someone who seems to have it all would engage in substance abuse. However, everyone has unique histories, circumstances and personality traits that can influence their relationship with drugs and alcohol. These are some of the traits common to high-powered professionals who develop addiction:
It’s common for wealthy professionals to look for new experiences that create exciting sensations. Sensation-seeking is a personality trait that can help people innovate and shake up the status quo by coming up with novel ideas and taking chances on ventures avoide
d by others.
However, sensation-seeking is also a trait common in those who engage in substance abuse. Johns Hopkins’ School of Medicine neuroscience professor David Linden, Ph.D., has suggested the very sensation-seeking qualities that can make someone a good CEO are exactly the same as those that make someone a prime candidate for addiction.
Linden’s theory is that the genetic variations responsible for the sensation-seeking trait cause reduced dopamine signaling in the brain, meaning these individuals require atypically high amounts of stimulation to achieve the levels of pleasure that other people find with
much lower levels of stimulation. This compulsion can lead to great things in a person’s professional life, all the while making them more susceptible to the pitfalls of drug and alcohol abuse.
2. Unresolved Childhood Trauma or Neglect
Many high-earners and high-achievers share a history of stressful or traumatic childhoods. When children don’t have their basic physical and emotional needs met, they often cope by acting out or by trying to fill the void with personal achievements. A person’s drive to succeed can also be the result of feeling as though love from parents is conditional and must be earned.
When substance abuse or violence is present in the household, a child may work hard to succeed as a means of compensating for the emotional damage they have sustained. It is very common for childhood abuse and neglect to result in the development of a substance use
disorder (SUD), regardless of economic status.
3. Personality Projection
Not everyone is emotionally equipped to deal with natural insecurity, but high achievers may go a step further and intentionally create a persona that fits the profile of an ideal professional. They may go out of their way to project strength, optimism and confidence even when they are internally struggling to stay afloat.
Over time, having to project a persona different from one’s own ca
n put someone in a dissociative state where they have less access to their own true feelings and desires. They may feel the need to blur the lines by drinking or doing drugs in order to reduce their feelings of alienation.
Many successful people achieve their stations in life with so
me measure of perfectionism driving their actions. Having exceptionally high standards and attention to detail is of obvious benefit in nearly any field of work, but perfectionism is frequently just a way to avoid feeling uncomfortable emotions that come with relationships and other elements of life outside of work.
While high-achievers with perfectionistic tendencies can often maintain an iron grip on work-related situations, emotions are not so easily controlled. When they flare up, and the person feels unable to handle them, that individual might try to quiet those feelings with substances rather than doing the necessary labor to work through the emotions.
Acute and chronic stress are factors that increase the risk of drug abus
e, and high-achievers face both types of stress on a day-to-day basis. After long days of making critical decisions, working with clients or business partners and performi
ng all the other duties of their leadership role, many professionals need to find a way to relax. Unfortunately, many use alcohol or other substances as a quick fix, not realizing it may actually cause them more stress in the long run.
What Does “High-Functioning” Look Like in Wealthy Professionals With SUD/AUD?
The problem of high-functioning AUD/SUD is more prevalent in high-income professionals. Someone with AUD or SUD who continues to go to work and function walks a precarious path. They may believe they’re still in control because they haven’t experienced the negative consequences of SUD or AUD.
People with AUD/SUD may be effective in their workplace during work hours, but misuse substances when they return home. They may even misuse alcohol or drugs during the workday, in between meetings and other obligations. When the individual in question is an executive or another crucial member of an organization, it’s common for colleagues to ignore or even cover up substance misuse in order to preserve the status quo and avoid “rocking the boat.”
This type of behavior can lead to escalating substance use, which may affect the work performance. For example, an executive who drinks during their lunch break might have too much and slur speech during an important meeting. Colleagues or employees often stay quiet until something goes very wrong.
The Role of Denial
Those with a high income often display the highest levels of denial about their SUD or AUD. One of the reasons for this is that “hitting rock bottom,” the impetus for many people to seek treatment, looks very different for someone who is wealthy. A CEO or high-level executive can afford to spend huge amounts of money acquiring drugs and alcohol without it significantly impacting their finances. Without facing financial consequences for their addiction, they can afford to ignore their growing substance use problems for months or years.
Busy professionals are often very reluctant to get treatment even when one or more people in their lives bring up the need for treatment. For many, it’s a case of excess self-confidence. When someone generate a significant amount of wealth and gains social status as a result, they may labor under the delusion they can do anything – including live with SUD or AUD. They may believe they can simply work things out on their own without professional help.
They may also be more sensitive to the stigma associated with drug and alcohol addiction treatment. Taking a leave of absence for addiction treatment can cause someone to fear that it will cost them clients or adverserly impact their career as a whole. Eventually, however, the following signs of SUD/AUD will make it clear they need support:
- Worsening job performance.
- Erratic work attendance and consistent lateness.
- Missing meetings.
- Avoiding socialization at work and skipping work-related functions.
- Declining hygiene and appearance.
These problems may not appear all at once, but as they continue to become more detrimental, it becomes painfully clear that addiction is not sustainable, even for the highly successful.
Find Hope at Beacon House
Although there is a strong link between income and drug abuse, people of any socioeconomic status can find themselves struggling with addiction. No matter your income level, drug use can quickly take away everything you’ve worked so hard to build. The only way to keep addiction from worsening your finances, health and happiness is to find an effective treatment program and begin your recovery.
Beacon House is a leading addiction treatment center in Northern California, offering substance abuse treatment programs for people of all backgrounds. Our experts on evidence-based treatment can help you overcome addiction through services like residential detoxification and levels of care, ranging from outpatient to inpatient.
To learn more about how Beacon House can help, call us at 1 (831) 372-4366. You can also get in touch with us online by completing our contact form. Don’t let addiction continue to overshadow your life. Contact Beacon House today.