Treating persons at the intersection of poverty and substance use: an interview with Dr. Dan Lustig, Ph.D., CEO of the Haymarket Center, Chicago, Illinois

Abstract

Of the over 70,000 overdose deaths in the US in 2018, More than 46,000 involved heroin and other synthetic opioids (Wilson et al., 2020). The explosion in opioid use and opioid deaths has drawn the critical attention of practitioners as well as researchers. One recent study suggested that poverty may be fueling Americans’ opioid crisis (Altekruse et al., 2020). While opioid use has not been confined only to those in poverty, of the thousands of Americans who have died from drug overdoses since 2006, most lived in poor areas where there were few job opportunities. The relationship between substance use and poverty is complex and impacts effective treatment options and methods. Several ideas of their relationship have been posited in the literature, including that one causes the other, or that they are risk factors for each other, or they exacerbate each other (Smyth & Kost, 1998). Some have suggested that personality traits are more connected to substance use, with poverty playing a moderating role (Sutin et al., 2013). A number of social determinants of health, including poverty have also been postulated as significant contributing factors to substance use, highlighting the lack of health care coverage and lack of trained and accessible providers (Dasgupta, BEletsky, & Ciccarone, 2018). This interview explores the economic and social conditions underlying the epidemic in opioid use, opioid overdoses, and the challenges of providing effective treatments to those struggling with both poverty and substance use. We discuss these issues with Dr. Dan Lustig, CEO of Haymarket Center in Chicago, Illinois. Haymarket Center is the largest not-for-profit community-based adult detoxification, residential, and outpatient substance abuse treatment facility in Chicago. It serves primarily homeless, indigent and exoffenders in the Chicago area.