America’s problems with substance abuse could be a result of classism, or in Marxist theoretical terms, the class conflict between the rich and the poor. In the United States today, there is undeniably a problem with wealth inequality, and unfortunately, attempts to resolve issues such as wealth inequality, substance abuse, health care access, education, and many other difficulties that people face on a daily basis are met with stark opposition from those in power, those with much to lose if society becomes more equal. Economic power is political power- even if you are not a lawmaker, you can buy one out to do your bidding if you have deep enough pockets. Two key problems presented in the Heritage Foundation’s (a heavily biased conservative think tank) series “America’s Biggest Issues” which directly relate to substance abuse are health care and education (Wood & Burke, 2018). Unfortunately, while they do correctly identify these topics as “issues”, people such as the Heritage Foundation, politicians, and the upper class do not wish to actually resolve them because doing so might result in a redistribution of wealth- an ending to classism, and they are willing to manipulate legislation through campaign donations, Super PACs, and lobbying in order to maintain the status quo.
Beginning with the obvious problem of health care, we can see that companies stand to profit tremendously from addictions to medications such as opiates. If you can get a patient hooked on painkillers, you potentially have a customer for life. One potential solution to this problem would be socialized medicine. If we remove the incentive to sell medications, and companies are instead beholden to legislation which serves the people, then fewer addictive substances would be prescribed. However, in our current situation, companies are driven entirely by profit, and due to classism, the patients who develop addictions are not seen as people in a state of suffering but rather as loyal customers.
We can compare opiate addiction in America to opiate addiction in countries with socialized medicine to see that the problem is exacerbated by our current healthcare system. According to an article written by Dina Gusovsky for CNBC (2016), America is responsible for the consumption of 80 percent of the global opiate supply. To quote Dr. Jan Van Zundert, in an interview given to the Cleveland Clinic’s Department of Pain Management, opioid addiction is less of a problem overseas “because healthcare is much more regulated in Europe” (Cleveland Clinic, 2018). If we were to reduce the incentive to profit off of citizens by socializing our healthcare, and then if we were to adopt stricter regulations regarding drug prescription, perhaps we could more adequately combat this epidemic.
The other major issue which the Heritage Foundation identifies is education. Public schools in America are largely funded through local taxes. This means that lower income areas have less adequate education systems, whereas wealthier areas have access to more resources to better educate their children. This directly impacts a child’s ability to go on to higher education, which in turn impacts their careers, which in turn impacts their economic status. According to the U.S. Department of Health and Human Services, rural counties saw a higher growth rate of opioid-related deaths and hospitalizations between 2000 and 2016 than urban areas (Ghertner & Groves, 2018). More specifically connected, this report also indicates that there is a strong correlation between geographical location, economic opportunity, and opioid-related health problems. Education directly ties into all of this for the aforementioned reasons: areas with lower incomes have poor education (and thus less economic opportunity) when compared with urban and higher income areas. And of course, education does not end with schooling. A greater national focus on the opioid epidemic, including readily available, state-funded information could serve to educate those in lower-income situations of the dangers of opioids.
The solutions to these problems would, of course, entail increased government spending. Although the United States already spends more per capita on healthcare than countries with socialized medicine according to the Peterson-Kaiser Health System Tracker (Sawyer & Cox, 2018), reforms to our current healthcare system would of course be costly- and met with opposition from those who stand to profit from our current system. Reforming our education system to provide greater resources to lower-income areas would also be tremendously costly and would almost certainly require federal legislation. This would entail taking wealth away from people in certain geographical locations and redistributing it to lower-income areas- and again, this would be met with opposition. This opposition is at least partially based in classism, in the ability to dehumanize those outside of one’s social class and deny them their rights, simply because the wealthy would suffer a bit as a result.