Pathways to Addiction: Poverty and Substance Abuse

Substance abuse develops for a range of reasons. Three common experiences can contribute to the development of addiction: trauma, stigma, and poverty. Over the next few months, I want to explore the role that each of these factors plays in the pathways to developing and maintaining addiction.

Pathways To Addiction: Trauma and Substance Abuse

Pathways To Addiction: Stigma and Substance Abuse

Too many people hold a stereotypical idea of what someone with an alcohol or drug problem “looks like.” This false image contributes to the belief that someone with a full-time job, a home, a vehicle, or a family cannot have a problem with alcohol or drugs. But in reality, substance and alcohol use disorders affect all kinds of people. 

You’ve likely heard the phrase, “Addiction doesn’t discriminate.” There is no single picture of what addiction or alcoholism looks like. At the same time, some factors increase a person’s risk of developing a problem with alcohol or drugs. The World Health Organization refers to these factors as social determinants of health, a group of non-medical factors that influence health.1

Poverty is one of the primary social determinants of health, making it a recognized pathway to addiction. While people from all socioeconomic backgrounds can experience substance abuse, people living in poverty are more likely to be affected. 

An ever-expanding base of research validates this observation. According to a study by Drug and Alcohol Dependence, opioid overdoses are more concentrated in “economically disadvantaged zip codes, indicated by higher rates of poverty and unemployment as well as lower education and median household income.”2 Additionally, homeless individuals have a disproportionately higher risk of experiencing an opioid overdose.3 

What are some of the connections between poverty and substance abuse? How does one affect and lead to the other? And what is the solution to this seemingly growing problem?

The Connections Between Poverty and Substance Abuse

While poverty alone does not cause addiction, it does play a role in whether substance abuse problems develop. Living in poverty places a tremendous burden on people whether they’re young or old. Both people born with limited resources along with those who experience it later in life face the same troubles. Some of the reasons poverty may lead to substance abuse include:

  • Poverty increases stress. Struggling to make ends meet places people under an incredible amount of stress. People commonly turn to substances to relieve stress.
  • Poverty leads to feelings of hopelessness. People living in poverty, especially those who have lived in it for years, often feel hopeless. The likelihood of rising above seems increasingly difficult. These feelings of hopelessness can lead to substance use.
  • Poverty influences self-esteem. Society emphasizes the importance of material success. Having limited resources can cause feelings of shame and diminished self-esteem. Low self-worth can drive people to drugs or alcohol.
  • Poverty affects social support. Strong social support networks made of friends, family, and colleagues are important to a person’s well-being. Individuals living in poverty may struggle to build social connections because they spend so much time trying to make ends meet each day. Limited social support can increase the likelihood of substance use.
  • Poverty limits access to healthcare. Healthcare is a massive expense for families. However, addiction treatment services are often the first recommendation when someone struggles with substance abuse. Limited access to adequate healthcare keeps people trapped in a cycle of alcohol and drug use that becomes harder to escape.

Substance Use Disorders Can Lead to Poverty

Addiction is a chronic, progressive condition that gets worse the longer it’s left untreated. People often sacrifice parts of their lives as their alcohol or drug use increases, including their jobs, homes, family, and overall stability. This means the connection between poverty and substance abuse can also move in the other direction. People who struggle with alcohol or substance use disorder are at a greater risk of experiencing poverty. 

Some people who use drugs and alcohol spend as much time and money as they can to stay under the influence. At its worst, buying substances comes before paying rent or bills, supporting a family, or even caring for basic needs. When someone expends all their resources on their substance use, they’re more likely to use themselves into poverty.

Research also supports this. A study published in the American Journal of Public Health revealed the connection between substance abuse and poverty. According to their findings, individuals with substance use disorders are at a greater risk of first-time homelessness. If their use goes untreated, they also have a higher chance of experiencing ongoing homelessness.4

Effective Treatment Must Address All Aspects

These various pathways to addiction prove that effective addiction treatment cannot be a one-size-fits-all model. There are as many paths to substance abuse as there are people struggling with alcohol and drugs. Neglecting to care for the aspects that make up an individual does a disservice and limits their potential for long-term recovery.

It’s challenging to find treatment services that address every part of the individual. But that’s exactly what Emerge Recovery sets out to do. We recognize that your story is your own, that traditional treatment approaches may not be the most effective method for you. No matter what your story is, you are no less deserving of recovery than anyone else.

To learn more about the Emerge Recovery difference, please reach out today. We would love to connect with you, learn more about your story, and find out how we can help you achieve recovery, whatever that looks like for you.


1. World Health Organization. (2019). Social Determinants of Health.

2. Drug and Alcohol Dependence. (2018). Urban-Rural Variation in the Socioeconomic Determinants of Opioid Overdose.

3. Social Science & Medicine. (2019). Association Between Homelessness and Opioid Overdose.

4. American Journal of Public Health. (2013). Substance-Use Disorders and Poverty as Prospective Predictors of First-Time Homelessness in the United States.

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