If we use a broad definition of drugs – to include alcohol, cigarettes, illegal and other socially unacceptable substances – it is clear that drug use is nearly everywhere. However, different people living in different areas may have different drug use patterns.
Deprivation can involve many things such as poverty, inadequate housing, poor education and lack of job or social opportunities. Although deprivation is often concentrated in particular areas, such as inner-cities, it is also to be found in smaller towns and rural areas.
Cigarette smoking has fallen among the middle classes in recent years but less so among working class people. The only growth market for cigarettes has been young women and particularly young working class women.
The picture for alcohol is less clear. In terms of alcohol consumption, women in professional households or who work full-time are those most likely to exceed the recommended weekly limits. People who are in managerial or professional roles are more likely to drink more, and more often, compared to people in routine or manual roles. According to the NHS Information Centre, in 2012, 17% of adults in managerial and professional households had an alcoholic drink on five or more days in the past week, compared to 11% of adults in routine and manual households. The proportion of adults exceeding 4/3 (male/female) units on at least one day in the last week was 37% for professional and managerial households, and 26% for routine and manual. For those exceeding 8/6 units, the proportion was 18% for managerial and professional, and 13% for routine and manual.
Similarly, for households that earned over £1000 gross per week, the proportion of adults who drank more than 8/6 units on at least one day in the previous week, 25%, was nearly three times higher than those households with an income of less than £200, which was 9%. There are also differences in the type of alcoholic drink consumed, with wines and spirits more likely to be used by middle class people and beers and lagers more by working class people.
The relationship between deprivation and alcoholism is less clear, partly because of the difficulties in defining and measuring alcoholism. Statistics of deaths among males for cirrhosis of the liver (an indicator of heavy, long term alcohol use) show that publicans and bar-staff, doctors and seafarers are most at risk. Among women, publicans, bar staff, hairdressers and women in literary and artistic occupations have particularly high rates of cirrhosis of the liver. Rates are especially low among women teachers, welfare and health workers.
The relationships between deprivation and illegal drug use have been highlighted in a number of research studies. The Advisory Council for the Misuse of Drugs report ‘Drug Misuse and the Environment’ (1998) stressed the following points:
- Deprivation is associated with the problematic use of particular drugs such as heroin and crack cocaine. Although problematic use of these drugs is not exclusively related to deprivation it is much more common among poor people.
- Rather than deprivation being related to whether people have ever tried drugs or not, it is more likely to relate to a lower age of first use, progression to dependence, injecting drug use, risky use, health and social complications from use and to criminal involvement.
- Deprivation is linked most strongly with the extremes of problematic use and least with casual, recreational or intermittent use of drugs.
- Deprivation often means a user is less likely to get care and treatment.
- The chances of overcoming drug problems are less among people who are disadvantaged. They have fewer positive alternatives and less access to meaningful employment, housing etc.
- Deprived areas often suffer from greater and more visible public nuisance from drug taking and supplying.
- Poor areas with high unemployment levels can provide an environment where drug dealing becomes an established way of earning money. Deprived areas might, at community level, find it more difficult to deal with drug problems.
Deprived people living in over-crowded and sub-standard accommodation are more likely to share injecting equipment and more likely to get hepatitis, HIV and Tuberculosis.
In other words while there is no correlation between whether people have ever tried illegal drugs (with the possible exceptions of heroin and crack cocaine) and deprivation there is a clear link between problematic drug use and deprivation. This does not mean all problematic drug users come from deprived areas or backgrounds. It does mean that a disproportionate number do.