Can you describe what a person with an addiction looks like? Can you cite an age, gender, race, profession, or another factor that primes a person to abuse drugs or alcohol?
Chances are, you can’t.
Substance abuse is remarkably common in the United States. In fact, the Surgeon General says, close to 70 percent of Americans abuse substances each year. About 8 percent meet diagnostic criteria for a substance use disorder each year.
Put everyone who abuses substances or needs treatment in one room, and you’ll see people from all walks of life. All ages, socioeconomic groups, and ethnicities would be included. All of them need help, and few of them get it.
The National Institute on Drug Abuse says less than 1 percent of those who need addiction care get it at a specialty facility.
How can we heal our community? It starts with understanding that no one is immune to addiction risks. And the more we know about how our backgrounds can influence recovery, the more we’ll heal in treatment programs.
- Race or ethnicity
- Income or socioeconomic status
- Mental illness
- Religious belief systems
We’ll also give you a list of resources you can use to conduct your own research.
Addiction and Gender
Researchers have long suggested that men develop addictions more frequently than women do, and men tend to dominate discussions about how substance abuse should be treated.
But as the research has deepened, we’ve learned more about what separates men and women with addictions, and that’s changing both prevention and treatment programs.
- Cultural expectations: Men once used illicit drugs at a higher rate than women, and researchers thought that was due to coding differences. Now, studies suggest young women are closing the use gap. As it grows more acceptable for women to take risks like men do, they’re using illicit drugs more often.
- Recovery rates: Researchers say a woman’s hormonal cycle can interact with her drug history. She may have strong cravings during the month that make her more likely to relapse. Men don’t have similar triggers since they do not have a menstrual cycle.
- Drug of choice: About 20 percent of women entering addiction treatment do so because of alcohol, researchers say. Only 10 percent of men do the same.
- Family obligations: Women who abuse drugs during pregnancy can face severe consequences, including arrests in some states. Women may also have primary responsibility for small children, and that keeps them from moving into inpatient treatment facilities. They can’t leave their kids behind.
But other women do just as well in mixed treatment programs. As long as they feel personally safe and their concerns are heard, they have no issue sharing with men.
We often associate substance abuse with youth. We picture carloads of teenagers meeting up in clandestine spots to swill alcohol or light up cigarettes. We know some of these teens won’t be able to stop substance abuse once it starts.
But addictions aren’t just the province of the young. Older people can and do develop substance problems.
- Benzodiazepines. These sedating substances work on the brain’s pleasure pathway, and they can spark compulsive use.
- Painkillers. Drugs like oxycodone often cause addictive brain changes. Older women are particularly vulnerable to this issue. Women 65 and older presenting for addiction care are three times more likely to cite painkillers than their male counterparts, researchers say.
- Stimulants. Drugs like Ritalin are crucial for people with attention deficit hyperactivity disorder. But they can cause brain changes and addictive issues.
It’s not always easy to spot an older person with an addiction issue, researchers say. Moments of confusion caused by drugs can be blamed on age-related brain changes.
And older adults may not face common consequences seen in younger people, researchers say. They may not lose their jobs, get arrested, or face financial ruin. Their addictions can deepen because people don’t suspect the problem.
Older adults may recover with treatment. Some benefit from programs that include physical care, so they can find new ways to treat the ailments they’ve been self-medicating with drugs. Others appreciate programs made just for seniors, so they can discuss issues, like illness in a spouse or fear of death, with others of a similar age.
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Race and Ethnicity
Addiction can be driven by genes, and some are closely tied to race. A gene variant seen in Asian people, for example, causes nausea after heavy drinking. That little shift could make alcoholism less likely in this group.
But some addiction choices aren’t influenced by genes as much as culture and systemic racism.
- Asians: 3.1 percent
- Hispanics: 8.8 percent
- Whites: 9.5 percent
- Blacks: 10.5 percent
- American Indians or Alaska natives: 12.3 percent
- Native Hawaiians or Pacific Islanders: 14 percent
Do these numbers vary because of genes or culture? Does a Hispanic person use drugs more frequently than an Asian person due to the influence of genes? Or does the culture that surrounds that person make drug use more permissible?
These are exceedingly difficult questions to answer. Individuals might be exceptions to each rule too, as no one is expected to be a perfect specimen of race. But when discussing addiction and drug use, it’s critical to acknowledge the role of institutional racism and societal expectations.
Sensitive treatment programs move beyond issues of language. Treatment teams can help their patients to understand how disparities among, wealth, education, housings, criminal justice, healthcare and more might shape choices, and they may use elements of the culture to boost healing.
Very few of us sit within the middle class. As traditional blue-collar jobs in manufacturing and resource extraction disappear, some families float to the top of the economic heap and others sink. Both groups face unique addiction risks.
- Experimentation often starts early. Researchers say teens from affluent families tend to begin drinking careers earlier than those in poorer communities. That early use could set them up for a lifetime of abuse.
- Financial barriers are less likely to exist. With wealth comes the ability to buy drugs without sacrificing the family budget.
- Some drugs are associated with power. A hit of cocaine has long been connected to wealthy, risk-taking, powerful men. Some affluent people may believe they must use to fit in with their preferred peer group.
- Drugs may be readily available. Street dealers mix drugs in poor neighborhoods, where they’re less likely to get caught. Just walking out the door in some parts of America can mean encountering multiple dealers.
- Stress is often prevalent. Researchers studying the opioid crisis say deaths have been concentrated in poor areas as families face intense pressure and few options. Drug use seems like the only way out.
People in both groups deserve evidence-based addiction care that homes in on the source of the issue and offers therapies that work. But people in poorer communities may not have insurance coverage, and they may face long waitlists for entrance into state-funded treatment programs.
About half of all people with a mental illness will also develop a substance abuse problem, says the National Institute on Drug Abuse.
It can be a matter of genetics. A vulnerability to one means a vulnerability to the other. But sometimes, substances are used as self-medication.
At one point, treatment teams believed in treating one issue first. If someone had an addiction and a mental illness, doctors believed addressing the addiction was critical. That could allow them to:
- Spot symptoms caused solely by mental illness.
- Assess the severity of the mental illness without the influence of drugs.
- See if symptoms got better when drugs weren’t in the way.
Unfortunately, this model didn’t always work. Some people were at deep risk of relapse as their mental illnesses worsened without treatment. And some people couldn’t focus on addiction recovery with mental health issues in the way.
Modern programs may blend therapies for both issues, helping people to recover from all that ails them at the same time. Since dual problems are so common in the addiction field, it’s not hard to find a program that uses this blended approach.
A belief in an afterlife and a higher power can be considered protective against substance abuse. Researchers say that religious belief tends to keep people from starting substance abuse in the first place. Those who do start tend not to use much. But the story can be a bit more complicated.
If you’re part of a religious community and you do develop an addiction, it can be harder to ask for help. Will you be outcast from the support you so desperately need? And will you be judged for developing the issue in the first place?
While people in religious communities with addiction may be in the minority, they certainly do need help. And plenty of addiction programs offer components that would appeal to someone with a religious bent.
Some support group programs, like 12-step groups, encourage people to lean on a higher power in the fight against addiction. For people already of a religious persuasion, that could be an easy solution to accept.
Where to Find Out More
We’ve given you many statistics about demographics and religion. But we’re sure you have questions we haven’t answered quite yet. We’ve developed a list of resources that might be helpful for independent research.
- American Society of Addiction Medicine: Physicians, clinicians, and other addiction experts participate in this professional medical society. The group publishes research regularly.
- Center for Substance Abuse Research: This organization is nested within a university. It leans on research done there to explain how drugs work and how substance abuse might be treated.
- Substance Abuse and Mental Health Services Administration: This group publishes research on both addiction risks and recovery rates. You’ll also find resources about drug use risks and blog posts about recovery on this website.
- National Institute on Drug Abuse: This organization is nested within the National Institutes of Health. It conducts research on how drugs work within the brain and how substance abuse can be effectively treated.