months ago, economist I came across an article about the drug problem in Scotland and this statistic caught my eye:
In Scotland, people living in the most deprived areas are 16 times more likely to die from a drug-related cause than those living in the most affluent areas.
The difference in overdose death rates between the rich and the poor is too large to be merely coincidence. This discrepancy requires an explanation.
One possibility is that a lack of money makes people depressed, and depressed people are more likely to abuse drugs to ease the pain of poverty. Another possibility is that both poverty and drug abuse are caused by a third factor. How can we distinguish between these alternative theories?
The same Economist article includes a graph showing equally startling differences in drug overdose rates across countries.
There appears to be little or no correlation between a country’s wealth and its drug abuse rates. Scotland’s GDP per capita is roughly the same as the European Union average, the United States is much richer than the European average, and Portugal is much poorer than the average. And yet, Portugal has the lowest drug overdose death rate.
So how do we reconcile the fact that drug abuse is highly correlated with income in a country like Scotland, yet there is little evidence that poverty causes drug abuse at an international level? One possibility is that both drug abuse and poverty are caused by a third factor.
We assume that poverty and drug use are both correlated with some aspect of personality. We also assume that every country has people with different personalities that make some more susceptible to drug use than others. And finally, we assume that international differences in per capita income are not caused by differences in national personalities. We are not saying that any of these assumptions are entirely correct, but we are arguing that they help us understand why drug use is strongly correlated with poverty in some countries but not across countries.
If we assume that the proportion of the population with personality traits that make them more susceptible to drug abuse remains fairly constant in both poor and rich countries, we would not necessarily expect to see more drug abuse in poorer countries than richer ones. Also, if we assume that the same aspects of personality that lead to drug abuse (such as lack of self-control) also lead to poverty, we can explain both the within-country correlation and the lack of cross-country correlation.
Is this the solution? Not at all. This doesn’t explain why there are such huge differences in drug overdose death rates between countries (and even between regions, as we see in the UK). There must be something else going on, but poverty alone seems unable to explain it.
One possibility is that some countries have legal systems that are more tolerant towards drug use. But this also does not seem to fit the data, as Switzerland and Portugal both rely on a softer “harm reduction” approach, whereas the United States and Scotland have much stricter enforcement of laws against drug use. In fact, strict enforcement of drug laws may actually increase overdose deaths by creating an underground market where the quality of drugs is highly uncertain.
Rather, I believe drug use is correlated with two factors: personality and local culture. Areas lacking community support systems have higher rates of drug abuse, and people with certain personality types are more likely to abuse drugs in certain areas. The worst off are those who live relatively isolated in a country with a lack of self-control and no strong support system for individuals struggling with life.
In the United States, Drug overdose deaths Nebraska and South Dakota. Both states have many small rural towns with a strong sense of community. North Dakota was once very similar culturally, but the fracking boom in the Bakken region brought an influx of many young workers who were isolated from their families and communities. North Dakota’s drug overdose rate is still fairly low, but it is significantly worse than its two neighbors to the south. Yet no one argues that the oil boom has impoverished North Dakota; in fact, the opposite is true.
In conclusion, poverty is probably not a direct cause of drug overdose deaths, but within a given area, factors that contribute to poverty are likely correlated with factors that contribute to drug abuse.
