Opinion|Health Policy
Where Did the Love Go?
How Late Capitalism is contributing to sadness, sickness, and substance use in an uncaring world.
Work. Life.
Work can be… stressful. Deadlines, the seemingly ever-increasing FICA withholdings, and Karen accusing you of eating her tuna salad sandwich in the break room. (1. It was egg salad. 2. No, I did not!) These kinds of stressors we are aware of. However, we may not be as aware of all the subtle (…and not so subtle) ways that the prevailing economic philosophy underlying Late Capitalism is influencing more than just how we work, but also the structure of our society, how we relate to one another, and even the functioning of our genes. This ideology is creates a system that promotes pervasive chronic stress and diminishes our natural supports leading to manifestations of sadness, sickness, and substance use.
Late Capitalism Loves “You”
“You,” truly are the apple of Late Capitalism’s eye. It’s not, “you,” as the person with hopes, goals, and desires. It is, “you,” as an atomized automaton and commodified consumer. The system is built to get us to consume as much as possible and the externalities of that are… damaging. That is if you view wealth disparities, income inequality, racism and sexism as “damaging.”
Tainted Love
Buy! Buy! Buy!
In the pursuit of endless inexpensive goods, forces have been set in motion to drive down the cost of labor. In a traditional Marxist lens, sexism and racism arose as tools to divide laborers to compete rather than collaborate in the labor market to drive down wages. An additional effect of these -isms are social conflict which drives relational stress in our day-to-day interactions with one another.¹
Tonight, We Are Going to Take Over the World!
There is only so much that domestic social conflict can drive down the cost of labor, this fostered the foundation of two of the pillars of late capitalism: globalization and automation. The globalization of labor markets and obsolescence of certain occupations due to automation has highlighted the precarious nature of employment. A sudden loss of a job can lead one and his or her family to destitution given over two-thirds of Americans have less than $1000 in savings.²
The Matthew Principle — The Rich Get Richer
Globalization and automatization although serving us in the provision of endless conspicuous consumption, most of the benefits have been felt by the wealthiest among us. This is due to accumulated advantage, the capital holding class had the excess capital to invest in these ventures and thus keep accruing the benefits of the excess capital that these business practices facilitate. The runaway effect of accumulated advantage has resulted in wealth disparities not seen since the Gilded Age.³ Wealth disparity and income inequality are troubling because of the consequences of relative poverty — the social ills of crime, homicide, and health disparity.⁴
Stress Begets Stress
So you as a worker bee are stressed by constant threat of poverty, it is understandable if you bring that stress into your home life. How you manifest expressions of stress in your home life deeply impacts the development of your children. Expressions of physical, emotional, sexual abuse or neglect and household, “disfunction,” — justice involvement, parental conflict and or separation, and substance use are considered Adverse Childhood Experiences (ACEs) and these ACEs have profound implications for a child’s neurodevelopment and predispose one to hypersensitivity to stress throughout the life course.⁵
The Cortisol Casino
What is the point of me telling you all this? The game is rigged and the pay-out is stress. Your brain and body is being inundated with a constant supply of the stress hormone — cortisol, and it is the dysregulation of cortisol that is responsible for a myriad of maladies. Cortisol is good for you… in the right context. If there’s a lion chasing you, the short burst of cortisol shifts you body into gear. It boosts your energy by rapidly metabolizing sugars, increasing oxygen intake, and redirecting blood circulation.
That’s a short burst. The problem is that it is “bursting” all the time because of the chronic stress we’re under. This results in long term changes in our physiology which lead to heart disease, diabetes, autoimmune disease, and even the shrinking of our brain.⁶ It is not surprising that given the chronic pervasive stress and the toxic effects on our health that people engage in coping behaviors to help ameliorate these uncomfortable feelings. However, some of these coping mechanisms are “healthier” than others — meditation, mindfulness, physical activity, creative activity, social engagement vs compulsive gambling, spending, gaming, fornicating, and substance use.
The Remedy? — The “Heroin Hug”
You’re poor. You’re discriminated against. You’ve been abused. There’s no support and no one seems to care about you. You are stressed out and you feel unloved. This is the recipe for the current Public Health Crisis: the Opioid Epidemic.
”Heroin feels like love — in the beginning. Finally, freedom from the pain. A warm hug. An answer from that constant longing to feel safe again. And, at first, it works.” -Testimonial at Coolmine Treatment Center
With a statement like that… it is no surprise that there is approximately 2.0 million Americans struggling with opioid use disorder.⁷ Opioid addiction is en vogue at the moment in the political discourse because it is killing White working class laborers who got hooked on Vicodin after an injury at the mill, middle class homemakers with a predilection for Percocet following plastic surgery, and teenagers trading up to heroin after unsuccessful raids on their parents’ medicines cabinets.
However, it is not just the warm hug of heroin that Americans are turning to find comfort from the stress of the World. There are nearly 21 million Americans with disordered use of substances — the most prevalent being alcohol with 15 million disordered users.⁸ How did we get to nearly one in twenty American being dependent upon substances? Read the article. There is a rich array of social determinants that influence substance use — racism, poverty, childhood abuse. However, all of which are externalities of our economic system and crystalize as stress on the individual. It just happens that substance use is one way to cope with the present circumstance we find ourselves in.
The Cure - Connection.
If we are looking to cure to the epidemic of substance use, we need to stop looking at it as a disease and instead as a symptom in a much wider problem — the chronic pervasive stress imposed by the externalities of our economic system.
The greatest resilience factor in the face of this stress is our social supports. We are living in a time where we are more “connected” than ever. 1000 “friends” on Facebook, 10,000 retweets on Twitter, and 100,000 views on TikTok! However, we are more isolated than ever. Americans are reporting fewer and fewer significant or meaningful social connections than decades past.⁹ Our social support networks are shrinking. And its impact on our mental health and substance use is showing. So what’s the solution?
The most radical act in treating substance use, the Most. Radical. Act. that can vanquish all the attacks waged by the whole global economic system, is — extending your hand in friendship with loving kindness to your neighbor.
References)
- Peters, R. M. (2006). The relationship of racism, chronic stress emotions, and blood pressure. Journal of Nursing Scholarship, 38(3), 234–40. doi: http://dx.doi.org.ezproxy.cul.columbia.edu/10.1111/j.1547-5069.2006.00108.x
- Vultaggio, M. (2019)Most Americans Lack Savings. Statistica. https://www.statista.com/chart/20323/americans-lack-savings/#:~:text=Dec%2018%2C%202019-,Personal%20savings%20in%20the%20U.S.,45%20percent%20have%20nothing%20saved.
- Huyssen, D. (2018). We won’t get out of the Second Gilded Age the way we got out of the first. Vox. https://www.vox.com/first-person/2019/4/1/18286084/gilded-age-income-inequality-robber-baron
- Anser, M.K., Yousaf, Z., Nassani, A.A. et al. (2020).Dynamic linkages between poverty, inequality, crime, and social expenditures in a panel of 16 countries: two-step GMM estimates. Economic Structures 9, 43. https://doi.org/10.1186/s40008-020-00220-6
- Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American journal of preventive medicine, 14(4), 245–258. https://doi.org/10.1016/s0749-3797(98)00017-8
- Greenberg, A. (2020) How the Stress of Racism Can Harm Your Health: and What That Has to Do with Covid-19. Public Broadcasting Station-Nova. https://www.pbs.org/wgbh/nova/article/racism-stress-covid-allostatic-load/
- HHS. (2019). What is the U.S. Opioid Epidemic. HHS. https://www.hhs.gov/opioids/about-the-epidemic/index.html
- Addiction Centers. (2020). Statistics on Addiction in America. Addiction Centers. https://www.addictioncenter.com/addiction/addiction-statistics/
- Bryner, J. (2011). Close Friends Less Common Today, Study Finds. LiveScience. https://www.livescience.com/16879-close-friends-decrease-today.html
