THE RELATIONSHIP BETWEEN SOCIAL INEQUALITY AND PATTERNS OF ADDICTION IN MODERN SOCIETIES

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THE RELATIONSHIP BETWEEN SOCIAL INEQUALITY AND PATTERNS OF ADDICTION IN MODERN

SOCIETIES

Abstract

Socio-economic status is one of the biggest factors that influence addiction in the modern world because it

defines the access to treatment and prevention services and recovery services. Differences in income

mean that people get different levels of coverage for their health care and this is an issue as regards

addiction treatment. In addition, the facilities are primarily situated in the most affluent areas, therefore the

policies are also associated with addiction since instability in employment leads to substance abuse. In

addition, occupational stress as a factor does not act uniformly across the classes when it comes to the risk

of addiction. Policies on drug testing at workplaces also affect the lower classes in one way or the other.

Other than employment, even basic needs such as shelter may be linked to addiction patterns; lack of

shelter or safe housing greatly increases the likelihood of substance use. Neighborhood takes the

connection between the location of housing and drug access and use and addiction rates further. The

following is how public housing policies are instrumental in determining community addiction trends

including the social networks that are helpful in the treatment of substance use disorder are different in the

level of stability of families, social resources, and stigmatization by social class. The compound also depicts

that in the legal structure there is a clear-cut division based on the socioeconomic status concerning drug

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Introduction

Social inequality as a determinant of health outcomes

in all the dimensions of the social determinants of health such as health service, education, work, housing

and community (Rehm & Shield, 2019). Thus, social factors are the principal source of differences in the

rates of physical and mental health. Individuals with low SES are more likely to die, be ill, use substances

and have substance abuse problems, and have psychiatric disorders than individuals with high SES

(Volkow & Boyle, 2018). For instance, opioid dependence and overdose death rates are higher among the

socially excluded who are also the economically excluded, the unemployed and the hopeless.

Discrimination also sustains the experience of trauma within such communities, and thus keeps the high-

risk coping mechanisms such as substance use (Rhodes et al., 2022). Similarly, lack of insurance and or

lack of easily accessible mental health facilities worsen mental illnesses in that they do not receive the

necessary treatment. This leads to increased prevalence of diseases, disability, chances of disease flare

services such as health, education, employment, non-discrimination and health care accessibility.

Overview of addiction patterns in contemporary society

Alcohol is a multifaceted issue affecting people and communities throughout the globe while addiction has

in the past been seen as a moral issue or criminal behavior; the modern study of addiction acknowledges it

as a chronic disease that has a biochemical, psychological, and social aspect (Phelan & Link, 2020). These

strategies are known as harm reduction and are part of a shift toward public health-based policies when it

comes to substance abuse (Pérez-Muñoz, 2023). There are a number of challenges that still exist in the

treatment of addiction in racially, ethnically, and economically diverse populations. Altogether, rates of

substance use have been on the rise over the last decades and substance use disorders are considered

one of the most costly global public health concerns today (Owens et al., 2021). In the United States, more

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been estimated that the cost of obesity-related diseases bordering on health cost, loss of working days and

criminal justice costs more than 0 billion yearly. Alcohol continues to be the most commonly abused

prescription painkillers and illicit drugs such as heroin and fentanyl. In addition to this nicotine addiction,

which is associated with vaping also continue to be a major public health issue, which is preventable. Apart

from the habitual consumption of substances, process addictions such as gambling also exhibit clinical and

societal issues.

residential treatment foster care can enhance the recovery process. However, such individuals have a poor

health insurance cover to enable them to access expensive treatment programs and a weak network of

support systems once they exit the centers (Nadelmann & LaSalle, 2019). The opioid epidemic in the

United States is a good example of such differences. Opioid abuse is a social issue that has impacted on

the society but the individuals in the low income areas have been impacted most. Since there are no

effective treatments available for such patients, synthetic opioids like fentanyl have caused havoc in such

populations (Nadelmann & LaSalle, 2019). Despite the fact that there is no a single factor that can be said

to cause addiction in totality, social injustice and exclusion are known to create enabling environment for

addiction in certain population groups. Such policies and programs that are directed at the peoples and

enhance the availability of the harm reduction services may help to prevent such behaviors and provide a

way out. But there are also structural social and economic inequalities that require erasure for the purpose

of equity. To this end, the best approach to dealing with this problem is a health promotion campaign that is

cognizant of the circumstances of the most at-risk groups.

Racial/Ethnic minorities who experience higher rates of addiction with mental health, chronic disease or

other co-occurring conditions and often encounter barriers to accessing best practices service (Owens et

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al., 2021). The low SES also predicts increased substance use once confounding factors such as childhood

trauma and neighborhood deprivation that increase addiction risk have been controlled for. Relative gains

addiction disparities without genuine policy reforms and interventions.

that either facilitate or frustrate receipt of care. Lower-income individuals are more likely to be uninsured

and therefore not have access to services for addiction (Merrill & Carey, 2022). There are publicly funded

treatment programs but they are usually slow to access and may even come with certain limitations.

However, if one is able to get monetary help, he/she may also face other issues such as transportation and

lost wages among the less fortunate (Mackey et al., 2018). They found that choice and autonomy over the

type and kind of treatment, providers, and treatment setting that an individual can afford are some of the

benefits of having wealth. The well-endowed can also go to private facilities where they provide expensive

and comfortable services. On the other hand, low income groups often are content with whatever options

are within their fiscal reach.

If addiction is not treated, it results in enhanced levels of social and economic marginalization and raises

the chances of being in contact with the criminal justice system, physical and mental illnesses, injuries, and

the equity in the delivery of services. Some cost-related factors may be also influenced by increasing

funding for free and affordable clinics. It is now imperative to turn the attention to the healthcare system and

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socio-economic determinants so that the gap of inequalities in the treatment of addiction can be well

addressed.

Geographic distribution of rehabilitation facilities across socioeconomic areas

counties with the highest income (Link & Phelan, 2023). Since the spatial relation has a great influence on

the utilization rates, those people who are living in the low income zones are likely to enroll and continue in

the substance abuse treatment programs. New rehabilitation centers for addiction are more likely to be

opened in those areas that have the potential for creating the demand that can lead to higher revenues

(Maani et al., 2021). But this does not incorporate the population that could be most helped by accessible

and cheap treatments. As stated by Link and Phelan (2023) ―Health care goods and services are

distributed according to the ability to pay more than according to the need to benefit‖ (p. 239).

This distribution of the rehabilitation service across the different county‘s income level show a clear

relationship between the socio-economic status of the population and the availability of treatment. The

current distribution of facilities, therefore, works against the health of populations instead of in their favor by

locating the facilities in rich populations. It is high time that every single patient who is a suffering substance

Having reviewed the economic implication on extent and duration of addiction treatment, it can thus be

concluded that economic influences a patient‘s chance of getting into and staying in a treatment program.

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The studies also indicate that the costs are prohibitively high, which is why a large number of people

suffering from substance use disorders cannot seek adequate treatment (Kulesza et al., 2019). Many

for those not insured or those with high deductibles and copayments (Keyes et al., 2019). Low-income

individuals are more inclined to attend publicly-financed treatment facilities. Nevertheless, these addiction

services are funded through public money, and this source of funding has been reduced leading to scarcity

and long waiting lists in the subsidized centers (Kulesza et al., 2019). Unemployment is also likely since the

poor cannot afford to sustain paid employment and treatment simultaneously, which narrows down the

choices even more. This makes it very hard for people to find the balance between work and recovery, thus

causing many of them to fall back into old ways. Housing and food insecurity are additional examples of

contextual factors that interact with demographic characteristics such as race, ethnicity, and gender to

worsen the recovery process (Kulesza et al., 2019). People from discriminated groups as well as those with

low socioeconomic status have a higher prevalence of substance use disorders but are likely to experience

Expenses of treatment also play a big role in the discontinuation of treatment early in the course of many

patients. According to the studies, the completion rates of the program are very poor among the people

who are on public assistance. Some of the inequalities include completion rates that vary from 30 percent

lower among the Medicaid patients in particular than those with private insurance (Keyes et al. , 2019).

Expenses of long term residency make people get outpatient treatment even when they are likely to

resume substance dependence. Outpatient treatment is also equally important in averting relapse; but

again, issues to do with costs of treatment, transportation, and time off work are still a big issue. Financial

factors at various levels of treatment and recovery from addiction are a major issue concerning minorities

and hinder program effectiveness. It is necessary to increase the public funding, improve the insurance

cover and develop cheap continued care so that everyone who suffers from addiction disease will have

equal chance of recovery regardless of his or her economic status. There is a need to adopt a more holistic

policy approach to the many financial problems that patients face in the course of their treatment, at the

end of programs, and in the long-term recovery process.

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Educational disparities and substance abuse prevention

School-based drug education programs in affluent vs. underprivileged areas

schools and communities in which they are delivered (Gunn et al., 2018). Hypothesis 2: There might be a

significant difference between schools in affluent, privileged neighborhoods which might have more funding

to provide a comprehensive, empirically supported drug education program, and those in underprivileged

neighborhoods which might face multiple demands with limited resources (Hansen, Braslow & Rohrbaugh,

2018). It is suggested that drug education programs must be designed to meet the specific needs of the

target groups. Gunn, Sacks, and Jemal (2018) compared drug rehab programs for women with dual

diagnoses of substance abuse and criminal backgrounds. According to Gunn, Sacks, and Jemal (2018),

such programs do not factor in how these women are oppressed by other forms of oppression such as

racism, sexism, and poverty in their recovery process. The researchers suggest culturally appropriate

therapeutic interventions that enable oppressed groups (Gunn, Sacks, and Jemal, 2018). It is for these

that worsen mental health and substance use disorders in vulnerable populations. This approach could be

used in school based drug education programs—instead of programs that are strictly based on the concept

of reasoned decision making; they should consider the various obstacles that underprivileged students

have to endure.

Karriker-Jaffe, Greenfield, and Kaplan (2018) revealed that individuals of lower SE had higher levels of

distress and alcohol-related negative consequences. According to the present researchers, people in lower

classes face more strains in the form of lower income, unemployment, loneliness and other such factors

that are known to have deleterious effects on the mental health of an individual which, in turn, causes

problem drinking. It is without a doubt that other stress factors exist that counter drug education anti-drug

use messages seen by underprivileged students. The interventions implemented in lower income schools

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to find social support. Therefore, in as much as school based drug education is intended to reach out to all

students, research indicates that such programs are most effective if they are designed to meet the needs

on the principles of behavior therapy. Underprivileged schools are limited by budget and resources yet the

students the schools serve are those who seem to have more complex stressors that are linked with

Substance abuse. Drug education programs for marginalized communities must respect cultural differences

and address social inequalities; offer and promote healthy and easily achievable ways of handling stress;

based drug education programs must address diverse needs of the students they target.

and is for this reason that truancy or poor performance at school may result from drug and alcohol use or

may lead to drug and alcohol use (Guarino et al. , 2018). On the same note, through the same study, Grella

and Stein (2020) asserted that substance use impairs cognitive functioning and academic performance.

And this mutual relationship proves that there is a need for the link between the academic performance and

substance abuse to be well understood. As for the risk factors, one hypothesis is that academic

disconnection results in drug and alcohol consumption. Guarino et al. (2018) provided evidence that young

people who in their teenage years had poor educational attainment and school connectedness are at a

higher risk of engaging in opioid and other drug use in early adulthood. Low academic self-identity makes

students to disengage from school, hang out with deviant peers, use drugs and alcohol as a way of coping

with frustrations, and hence, drop out of school (Guarino et al., 2018). It can be one protective measure to

avoid students‘ disengagement from learning or to support students who are at the risk of disengagement.

help explain lower GPAs, standardized test scores, and graduation rates among the substance using

students (Grella & Stein, 2020). It remains crucial to guarantee that the students provided with support

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services and rehabilitation to attain good grades in their studies. It can be postulated that academic

performance is inversely related to substance use in adolescents and young adults. Drop out students may

with a view of stopping the cycle. Some of the measures that are employed to ensure that the troubled

youth are back on the right track concerning their schoolwork may be helpful in preventing the young

person from developing an addiction later in life. However, accessibility of treatment is helpful in the sense

that it helps the affected students to recooper learning capacity and other chances they might have missed

out as a result of using substances. It is good stated that the present study calls for an integrated

prevention program that targets educational enrollment and substance abuse.

colleagues (2022), the issue of gentrification and homelessness are entwined with addiction and, therefore,

the problem has to be solved further down the line. Universities should expand students‘ and faculty

members‘ understanding of addiction and reduce stigma by applying the principles of public health to

curricula across disciplines. The readers who may benefit from the information about risk factors and

practical strategies are the students from social work, medicine, criminal justice, education, and urban

planning. According to Galea and Vlahov (2021), the addictions that are found in urban settings have their

cause in displacement in the urban area, low income, and scarcity of resources. Researches and

partnerships with the universities and the community can help in trying to prevent and intervene in the at

risk groups. Garland and Howard (2018) in the addiction science stated that there is need to employ

evidence-based mindfulness interventions, which can be done through conducting research in various

academic departments of universities and evaluating the success of new programs. And they accept the

idea that mindfulness can help to identify techniques for the management of distress and other skills

regarded as relevant to the recovery process. Universities and colleges also have the possibility to refer to

the comprehensive prevention internally. This includes substance use disorder early identification regarding

the faculty, staff, and students and recovery services and prevention. A public health approach to alcohol

and drug dependency means that addiction is treated as a chronic illness that requires treatment for the

rest of one‘s life and not as a moral issue. Multifaceted and extensive prevention and promotion programs

Family stability across social classes and its effect on recovery

experience other structural vulnerabilities that can worsen the process of getting better (Cano-Hila &

Argemí-Baldich, 2023). Braveman et al., 2019 point out that health equity is a form of equalization through

the provision of resources and opportunities to groups that experience structural barriers. Some of the

social determinants of health which continue to hinder the marginalized groups from accessing better

treatment programs include; Cano-Hila and Argemí-Baldich (2023) pointed out that for people getting out of

drugs, treatment and support from their significant others to reintegrate into society is important. However,

for the groups that are socially excluded, family units are often associated with conflict and instability. Most

of the people struggling with substance use disorders have been raised in unstable families or even in

foster care, and they lack emotional or financial security. Therefore, the lack of family support during the

rehabilitation process results in a higher probability of relapse and homelessness after the treatment (Cano-

Apart from the support systems, other factors such as the socioeconomic status greatly influence the

effectiveness of the addiction treatment. According to Bourgois et al. (2018), structural vulnerability can be

defined as the disadvantaged position of certain groups to experience harm due to the organization of

power and resource division. The impoverished and socially disadvantaged individuals and populations

cannot afford to pay for expensive and personalized treatment programs that would facilitate their recovery.

Many of the state-funded facilities are saturated and do not offer the amount of time necessary to treat

severe addiction cases. As such, the disadvantaged individuals experience relapse due to early discharge

from publicly-funded recovery centers (Cano-Hila & Argemí-Baldich, 2023). It can be stated that the familial

relationships and patient‘s social status can influence the recovery rates. Substance addiction often renders

people from underserved populations unable to secure adequate support and resources to overcome

dependency. In order to advance health equity and offer equal chances that do not depend on one‘s

income level or race, there is a need for targeted interventions that would address the specific needs and

concerns of the disadvantaged populations (Braveman et al., 2019). Applying publicly funded programs for

the reintegration of released persons can lower the likely causes of relapse among the released individuals.

Community resources for addiction support in different neighborhoods

Effectiveness of the recovery support systems from substance use disorders at the community level is also

from substance use disorders but also are limited in their ability to seek sufficient and adequate treatment

and assistance. Some of these include; Poverty: this triggers or maintains substance use, fosters

unemployment, homelessness and shame; barriers to personal and social reparation or reconstruction

(Benfer et al. , 2021). As Becker and Chartoff argue, the unfortunate reality is that stress resulting from

social prejudices really does alter the brain in a way that puts individuals at higher risk of use of

substances. The needy in this respect are the one who are most likely to be involved in substance use

hence the difficulty of getting help. These are the rights to treatment centres or, where appropriate, mutual

aid such as Alcoholics Anonymous or Narcotics Anonymous for the patient. However, as Blocker & Fahey

(2020) also mentioned, such groups are used often based on time, transportation, and other factors that

are in many instances inaccessible to the marginalized groups. Such meetings may not be convenient in

While mutual aid groups function as sources of social support for the communities, the ones with limited

economic capital received fewer quantities of recovery assets (Benfer et al., 2021). Investments are

needed to develop treatment centers, self-supporting meetings, childcare services and other support in the

areas that have none or limited coverage. Most advocacies is also needed in housing, to ensure more of

these units are developed; in getting people employment, so that they can be trained and placed; and for

addiction to be recognized as a disease, not a person‘s character deficiency. Solutions that target all social

domains of vulnerability are the most helpful for the target population in combating the rates of addiction

that are too high. As we can see, the improvement of the health of people in Britain expands through and to

the politically correct policies and measures, and to certain problems which the weaker part of the

population faces.

Social stigma and its varying impact across socioeconomic groups

Stigma is also evident in that societal perception of addiction varies with the status of the society in

move directly to heroin. This leads to the conclusion that heroin addiction is confined to the inner cities and

affects only those in the lower income bracket (Hansen, Braslow & Rohrbaugh, 2018). However, the current

opioid epidemic that is primarily driven by prescriptions of pain relievers cuts across the class divide

(Guarino et al., 2018). Despite the variations in the resultant effects, addiction problems are mutual among

all classes. These changes in the societal attitudes are not mere changes in perception but have effects. In

interviews with marginalized women, Gunn, Sacks & Jemal (2018) discovered that social stigma related to

substance abuse and imprisonment leads to emotional suffering. They described their participants as often

facing judgment and assumptions that they were bad parents or employees because of these stigmas. This

then adds to the feelings of stigma and loneliness they had towards their drug dependency and criminal

backgrounds (Gunn et al., 2018). Here various discriminations intersect which makes class, gender and

They can offer more equal services at the provider level, and at the same time; they can advance the

knowledge of such diseases. Similarly, Hansen, Braslow and Rohrbaugh (2018) argued that psychiatrists

ought to appreciate the extent to which a patient‘s environment is a crucial factor in treatment as or more

than the treatment protocol itself. Doctors can use structural competency approaches in identifying

structural impediments within the sociocultural context of the live environment. It shows how one has to

challenge the notion that health behavior; for example addiction, is purely an individual decision rather than

an issue of social inequality. As for one gets this much refined learning that plans for this diversity of the

human endowment, the fight against prejudice within the health facility is well addressed. Thus, one can

argue that substance addiction manifests itself at all the levels of society, although, approaches towards it

as well as measures to it are not indifferent to class, race, and gender. Since prejudice is one of the social

determinants of such diseases, when the issues are highlighted healthcare workers and units in charge of

handling such diseases can aid in eradicating prejudice and assist in working on better structures to

support such people. However, elimination of negative social norms is still a significant problem that must

be campaigned for all the time.

Disparities in legal penalties for narcotics offenses based on socioeconomic status

brain disorder that people cannot choose, but public policy continues to stigmatize and criminalize drug use

and possession, which has a disproportionate effect on minorities. As Rhodes et al. (2022) have noted, the

ability to access treatment programs can also be determined by one‘s social and economic status. Any

action aimed at preventing and treating addictions, such as methadone therapy, is not available to all

individuals to the same extent and may not be as effective in some cases. The disadvantaged populations

stay disadvantaged, as they have less access to treatment and support, and they are punished more

severely for violation of drug laws. In the words of Rehm and Shield (2019), the ―greatest shares of the

disease burden of mental and substance use disorders are placed on the shoulders of people who have the

least possibility of addressing those burdens‖ (p. 3). This suggests other systematic causes that contribute

to stigma and inequality. Some of the populations that may suffer from mental disorders include low income

society where Solutions include providing more opportunities for the people in the form of treatment

centers, reducing use of prisons as punishment, educating the judiciary and the jury, popularizing and

educating people on issues of health, eradicating poverty. With the discovery of the biological nature of

addiction, the justice system needs to become more ethical and humanistic in its handling of drug-related

Access to legal representation in addiction-related court cases

The right to an attorney can considerably affect the outcomes of all legal cases connected with substance

use disorders. Owens, Benight, and Rogers (2021) confirmed multiple barriers patients from the racial and

ethnic minorities with substance use disorder encounter, including no legal representation when seeking

help. This can be in congrue with the fundamental cause theory that asserts that usually, health and

cannot afford quality lawyers meaning their cases and compensation will not turn out the best. The

philosophy of harm reduction serves to further explain this matter in the following ways. According to Pérez-

oneself and others. However, the US legal system continues to penalize substance use even if science

shows that this practice enhances multiple adverse consequences for the person and the public. The poor

are unable to employ the services of lawyers to apply for their rehabilitation and therefore end up still in jail.

This is something that portrays economic disparity and how those affected do not get a fair legal justice let

alone the principle of least harm.

addiction-related issues are reduced to punishment rather than providing the necessary treatment to the

minorities. This is contrary to harm reduction philosophy that is grounded on compassion (Pérez-Muñoz,

2023). The kind and quality of legal assistance received significantly determines the outcomes of the case

while being closely tied to such factors as financial means and social standing, which is in contrast to harm

reduction frameworks that seek to provide justice to people suffering from substance use disorders. In line

with the fundamental cause theory, socioeconomic factors explain wellness outcomes within societies to a

greater extent (Phelan & Link, 2020). Hence, there is need to develop addiction support systems, which

include legal assistance in reducing barriers to rehabilitation especially among the marginalized groups.

Such efforts therefore align with the tenets of harm reduction approach and social justice. The combating

representation deficiencies in tandem with racism and poverty are among the critical actions that will lead to

fair justice concerning legal issues surrounding addiction.

stress aggravates vulnerable statuses because inequalities are amplified at the intersection of multiple

axes. Thus, programmes such as drug courts may end up helping privileged groups more unless

specifically designed to avoid this. This fact that those who are confined in jails and prisons are mostly from

the marginalized sectors is beyond doubt. As Dunbar et al. (2018) show through multilevel analyses, risks

or counseling entail charges many of them cannot meet. Due to the high costs of posting bail or hiring an

attorney, low income earners are usually found to be convicted more and given stern punishments (Dolezal

& Matsick, 2019). Despite their aim at reducing overcrowding in correctional facilities, these programs are

also marked by class. For instance, veterans‘ courts are specific to the military, and drug and mental health

courts primarily target offenders with social capital and contacts. Lacking equity mandates, these

rehabilitation-focused diversion initiatives inherently omit the disenfranchised (Dunbar et al., 2018). Non-

completion of stringent supervised release can lead to resentencing, a harsh penalty for individuals who do

not have other resources to rely on.

efficiency against the equality agenda when constructing diversion policy. Dolezal and Matsick (2019)

support the use of universal screening assessments to ensure all defendants are properly evaluated and

placed in correct rehabilitation programs. But, needs-blind access poses the problem of stretching thin

scarce program resources. An equitable system would ensure that the minority enrollments are

proportionate to the broader incarcerated populations and that such groups as women, minorities, and

LGBTs are reasonably represented (Dunbar et al., 2018). While administratively more cumbersome, such

safeguards can mitigate the risks of diverting individuals through other pathways from further exacerbating

the overrepresentation of justice-involved individuals from low-income populations. Socioeconomics

evidently sort defendants into tiered categories within the criminal justice system. Underexamined structural

inequities are sometimes realized through diversionary measures such as specialty courts. Thus,

acknowledging complexity in policy decisions and utilizing intersectional analysis, stakeholders can strive to

render alternative adjudication more encompassing. Every person should be given fair chances for

rehabilitation and a second chance without necessarily going through sentencing.

For instance, there is empirical evidence that demonstrates how social inequalities can significantly further

various forms of addiction through various channels. People who belong to discriminated or marginalized

groups may use substances to deal with stress factors or trauma (Merrill & Carey, 2022). Furthermore, poor

educational standards and fewer chances of employment can also contribute to risk factors for addiction in

occurrence of the adverse outcome of problematic substance use. Income inequality erodes social capital

and social connectedness, which studies have associated with increased alcohol consumption and

dependency (Merrill and Carey, 2022). This phenomenon is partially explained by the unemployment stress

hypothesis—job loss or permanent financial pressure can lead to alcohol dependency as an unhealthy

coping strategy. Therefore, people in the poverty bracket are at a greater risk of developing alcohol use

disorders (Merrill & Carey, 2022). This exacerbates these risks especially among vulnerable groups due to

disparities in health care and treatment.

particularly when such groups‘ communities have no chance of economic achievement (Mackey et al. ,

2018). The minority stress theory explains that owing to prejudice and prejudice-related outcomes, one

experiences cumulative psychological stress, the outcome of which is substance use. Research shows this

effect across various ethnic minorities: Societal victims include indigenous peoples and African Americans

(Merrill & Carey, 2022). Substance use disorders can also, in turn, because inequality through different

processes as will be illustrated below. Substance dependency pulls down the client socially and

economically: dependency significantly reduces the ability to undertake roles that enable a client to meet

social and financial responsibilities; thus, a client increases inequality. While criminalizing drug use it

impacts the minority group and the poor most and compounds their position on marginalization (Mackey et

al. , 2018). All in all, the cycles of oppression and addiction interconnect to intensify each other‘s effects.

However excessive substance use can be observed in all the aforementioned categories irrespective of the

status. As with all these theories, it is vital to bear in mind that while members of socially disadvantaged

groups are considered to be at higher risk than others, nobody is immune (Merrill & Carey, 2022). This is

why universal interventions and prevention measures are required: for all those ‗Wait and die‘ patients, for

the survivors and for those who face early mortality. Multiple approaches should address reasons for

disparities other than substance use since clients have complex issues. Regulations and practice of harm

minimization informed by research have possibility of aiding in dealing with substance use stemming from

health for social justice seems as the most promising approach toward addressing structural relations

between oppression and dependence.

The implications for policy-making and social interventions on the relationships between social

advise on the following preventions including those that relate with adverse childhood experiences, creation

of economic capital and improvement of the effectiveness of treatment. Incorporation of liberal social

policies such as UBI, PFL and UHC might help build even and robust societies. In place of assuming that

addiction is a personal character deficiency that affects a specific individual, policy-makers should come up

with solutions that will be advantageous from a systemic perspective for everybody. In addition, the macro-

level changes Dingle, Cruwys, and Frings (2020) summed up the SIFs in substance use and recovery at

the micro-level. On this they explain how normative concerns, behaviour and self-categorisation of group

memberships can compel people into and out of addiction. Interventions designed at counteracting the

group dictates that encourage addiction while encouraging recovery support systems may help to disrupt

the dynamics of addiction that social injustices organise. For example, Karp (1999) notes that mutual aid

groups are given friendship—elements that clear addictive disorders in members. Therefore, only wide

target measures incorporating structure and identity factors will be most effective for addressing the

unfairness of addictive disorders‘ origin. Decision makers should consider the CBPR models that work with

vulnerable audiences that have the agency to shape the processes. That is, a policy focus on recovery

stories might promote more inclusive policy advice for substance use disorders among marginalized

communities.

Call for integrated approach to address social inequality in addiction treatment

The COVID-19 crisis made the inequalities and barriers related to getting addiction treatment even

pandemic (Compton & Jones, 2019). Therefore, practicioners must continue to address addiction as

complex, what entails that harms related to addiction should also be marked and responded to as complex

and with interventions, going to the root of addictions. Integrated treatment is known as a protocol to

address all the clinical, psychological and social dimensions of the problem. This helps to have a wider

viewpoint as to how all possible needs that may be present in an individual can be satisfied. For instance,

psychosocial counselling and medications for opioid use disorders, the treatment results are improved

(Chisholm et al. , 2018). But the system being implemented herein has been designed in a manner that

only specific strata are allowed to touch it. Discrimination in healthcare also included affects the people of

color, homeless and low-income people, sexual and gender minorities (Compton & Jones, 2019). It is for

this reason that at policy level interventions are required to complement the integrated treatment approach

boosted. This can be done through the provision of workforce development activities to ensure that there is

workforce diversity of addiction professionals. Besides, other upstream strategies like paid Sick leave,

affordable housing, free and fair economic opportunities to the downtrodden communities will also improve

health equity.

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