If you think drug addiction is ‘self-inflicted’, you’re part of the problem

We all have wishes, like getting a better job, finding love or owning a Ferrari. Mine would also include some ambitions for the field of drug addiction.

December saw the launch of the government’s new 10-year drug strategy, “From harm to hope”. A worthy title with some notable and welcome content, not least the commitment to invest in specialist drug treatment, following a decade of savage budget cuts. Make no mistake, this was a bold move by a Conservative government that isn’t prone to prioritising the needs of people who have problems with drugs. After all, this doesn’t play well with voters who perceive these individuals’ problems as self-inflicted, taking the view that “they got themselves into this so they can get themselves out of it”.

However, it is inevitable that we will carry on investing record amounts of money in drug treatment until we tackle the causes that propel people towards needing treatment in the first place. Inequality is at the heart of why so many become physically and psychologically dependent. Drugs don’t distinguish between rich and poor but the impact they have on these bookends of society differ radically.

While those with the means are able to carry on using drugs with little consequence, those without feel the impact more than ever. For some, funding their use of drugs will see them engage in activities they previously thought unimaginable, such as stealing from or lying to family and friends. Their risk of dying as a result of using drugs is also amplified compared to their better-off peers.

Whether we’re talking about mental ill-health, physical illness or dependence on drugs, they all start with the same core ingredients of disadvantage. Lack of hope and opportunity, poverty, inadequate housing, unemployment, part-time or zero-hours contracts, lack of education and so on. None of this is particularly revelatory, but there is little sign of anything changing. Worse, the gap between rich and poor, far from contracting, has expanded in recent years.

This government, like many before it, not only fails to accept the existence of inequality but also spins information to show the “progress’’ they are making in reducing aspects like child poverty. How can we ever change these deep-rooted issues of inequality unless there is public acknowledgement that they exist?

Just like climate change, the evidence pointing to deepening inequality is abundant and only a marginal few deny its existence. It’s not simply that inequality is bad for the most disadvantaged – it is bad for all of us.

As Kate Pickett and Richard Wilkinson pointed out in their book The Spirit Level, we are all poorer when societies are unequal. Whether through losing a potential workforce or the significant expense of providing services from taxpayers to deal with the consequences of inequality, no one benefits.

Uncomfortable as it might be for us to admit, we don’t just need our government to acknowledge how inequality drives problems with drugs – we all have to accept this fact. One is dependent on the other, and as long as we continue not to care and view these problems as self-inflicted, our government has a mandate to avoid tackling inequality.

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This isn’t a straightforward problem with a neat policy solution. It requires a seismic shift in how we organise society. Think of this as akin to the monumental change that happened 70 years ago, when the NHS was established. It wasn’t just about money, important as that was, it was about changing attitudes and beliefs. An ideological shift from individual responsibility for health to collective responsibility for each other was fostered, ensuring that no matter how little you had, the state would step in and support you when needed.

It’s this type of conversion of belief and ideology that we now need on inequality. For decades, we have drifted into and supported the idea of individualism, fostering the negative and stigmatising view of those who have problems with drugs. But like these people, we all have the capacity to change. We can help our government see sense and generate the ambition to eradicate inequality, but only if we are willing to accept its existence, that it’s wrong and that it’s not inevitable. Taxpayers’ money must be spent to make this happen.

Without this collective commitment, the prognosis is bleak. Expect another record to be set for drug-related deaths and alcohol fatalities, more family and relationship casualties and, grotesquely, those with means to be further insulated from all of this. Anyway, I’ll cling on to the idea that wishes do sometimes come true. It’s not much but it’s all I have.

Ian Hamilton is a senior lecturer in addiction and mental health at the University of York