We are moving in the right direction, and we must accelerate and strengthen CDC’s continued investments in prevention to reduce overdose deaths. Expanding access to evidence-based treatment for substance use disorders—including medications for opioid use disorder such as buprenorphine and methadone—is important, in addition to building more community-driven interventions and promoting education and early intervention to prevent substance use disorders before they begin. The COVID-19 pandemic impacted Americans in almost inconceivable ways including illness, the loss of loved ones, job loss, financial stress, food insecurity, social isolation, and learning loss and the interruption of school-based services for millions of children.
Alcohol-Induced Mortality
Looking at death certificates from 2017 nearly 75,000 people died in the U.S. in 2017 from liver disease and alcohol-related conditions, a steep rise from 1999, when 36,000 died from those causes. Women used to die at lower rates from these conditions, but that gap has closed.11 As reported first by Case and Deaton and reiterated in their upcoming book,12 rising morbidity and mortality among whites due to accidents, drug overdoses, alcoholism, liver disease, and suicides means reduced overall longevity. These deaths are alarming businesses, too, as there are more suicides in the workplace than in the past.13 I expect that suicides, as well as overdose deaths, are undercounted.14 This should not be surprising as suicide is generally more stigmatized than accidental overdose. The most recent Florida data suggests that 1 out of 3 opioid overdose deaths, and an even greater share of cocaine deaths, are not reported.15 So, deaths of despair, may be occurring more frequently than we have thought. Other research suggests that the relationship between drug overdose rates and economic decline may vary depending on the specific drug being considered. Monnat and colleagues (2019) found high rates of prescription opioid overdoses and overdoses involving both prescription and synthetic opioids to be clustered in more economically disadvantaged counties with larger concentrations of service industry workers.
Mortality
Future studies should consider multiple causes of death involving alcohol use (Polednak, 2016). Potential misclassification bias in death certificate data cannot be ruled out, but underrecognition of alcohol use disorders would likely result in lower recorded death rates (Castle et al., 2014). We examined the distribution of alcohol-induced mortality by type of injury and regional and sociodemographic characteristics using counts, percentages, and age-adjusted mortality rates. To assess temporal trends, we initially estimated a 5-year simple moving average (SMA) for AAMR. While SMA smooths inter-year variations in rates, it does not provide annual or average annual percentages for trends over time.
EXPLANATIONS FOR THE RISE IN WORKING-AGE MORTALITY FROM DRUG POISONING AND ALCOHOL-INDUCED CAUSES
However, we still have a long way to go before insurance companies recognize and provide coverage for substance use disorders on par with other chronic diseases. Theoretically, “despair” or other forms of psychological distress may help to explain substance-related deaths because they reflect behaviors of individuals who are potentially depressed, distressed, and without hope for the future (Baines, Jones, and Christiansen, 2016; McLean, 2016). A formal definition of “despair” as a noun is “the complete loss or absence of hope” or “a cause of hopelessness”; the verb “to despair” means “to lose or be without hope,” and “to lose all hope or confidence” (Merriam-Webster, 2020; Lexico.com, 2020). Recent research has attempted to examine trends in psychological distress and despair-related behavior. Here the challenge of how to define “despair” is important because there are no well-developed scales or validated measures of despair or hopelessness (Goldman, Glei, and Weinstein, 2018; Muennig et al., 2018).
Drinking Alone as a Teen May Foreshadow Future Alcohol…
Rates remained constant throughout most of the period among Hispanic females ages 25–44, only increasing slightly in the most recent period, between 2012–2014 and 2015–2017. These mortality trends are consistent with those identified by Kerr and colleagues (2009), who found a significantly lower volume of alcohol consumption among Hispanic and Black relative to White respondents in six U.S. national alcohol surveys conducted between 1979 and 2005. The trend in substance-induced deaths is not abating, and the prevalence of substance use disorders (SUDs) remains high. A 2017 study found that 7.7 million Americans (2.9% of the total population) had a drug use disorder, while 15.7 million (5.9%) had an alcohol use disorder (Segal et al., 2017). A recent study showed that increases in clinical diagnoses related to alcohol misuse, substance misuse, and suicide ideation/behavior between 2009 and 2018 largely mirror the broader mortality trends from these three causes (Brignone et al., 2020). The rise in drug poisoning deaths is well studied, and scholars have offered plausible explanations for this phenomenon.
- For example, a recent systematic review on this issue, covering a variety of countries, suggests that there is little evidence for substantial recent changes in rates of adult mental illness (Richter et al., 2019).
- The WCRF’s position, which is similar to that of the World Health Organization, is that there is no ‘safe’ level that does not increase overall cancer risk.
- There were 1,047 fatal drug overdoses in 2017 in that county, but an opioid-specific International Classification of Diseases (ICD) code was included on only 45 death certificates (CDC, 2020b).
- Stricter policies, enhanced addiction treatment, and increased public awareness can help curb this deadly trend.
Psychiatric disorders, mood disorders, anxiety disorders, and increased suicidal behavior are all dangerous side effects of alcohol abuse that can lead to an untimely death. At Resurgence Behavioral Health, we have highly trained counselors and psychologists to assess the negative impact of abusing alcohol. Upon take in, we will provide a mental and physical well-being test to put you on the right road to recovery. Excessive alcohol use led to approximately 2.5 million years of potential life lost, also known as YPll.
They expand their potential explanations for these trends by describing how the life circumstances of less-educated Whites have deteriorated over recent decades. They cite several examples, including the deterioration in wages, declining labor force participation, and declines in job quality among those without a college degree; the rise in family breakdown, including divorce, nonmarital childbearing, and single parenthood; changes in religious practices; and the decline in union representation. Many of Halfway house these factors are features of largely working-class communities where manufacturing jobs disappeared long ago and where unemployment has become a permanent state.
Other medical conditions, such as infectious diseases and cancers, were also not behind these changes, as outcomes for certain medical problems actually improved. The SMA increased by 38.1% among males, from 11.22 to 15.50 deaths per 100,000, and by 80.9% among females, from 3.26 to 5.90 deaths per 100,000. Based on the latest joinpoint segment, recent death trends in males increased at an annual rate of 12.5% (95% CI 6.4, 19.1) from 2018 to 2020. Similarly, the latest trend in females increased at an annual rate of 14.7% (95% CI 9.1, 20.5) from 2018 to 2020 (Fig. 1). Reduce overdose risk and access to lethal means of suicide through harm reduction programs including syringe services programs, access difference between drugs and alcohol to overdose prevention medications like naloxone, and promoting safe storage of all firearms.
- Research suggests that the risk of developing this disease does not increase gradually, but instead accelerates the more a person drinks over time.
- They also provide evidence of increasing morbidity, reporting concurrent declines in self-reported health, mental health, and ability to conduct activities of daily living and increases in chronic pain and inability to work.
- Our results were reported as average annual percentage changes (AAPC) in AAMR and annual percentage changes (APC), along with their corresponding 95% confidence intervals (CIs).
- Addressing preventable causes of death through targeted public health interventions, mental health and substance use disorder treatments, and enhanced social services could substantively reduce the life expectancy gap.
- However, ongoing population surveys and other nationwide surveillance on comprehensive indicators of adult mental illness are scant, making it difficult to relate trends in those conditions to other important health and functional characteristics, such as substance use, disability, employment status, and mental illness–related mortality.
Consent for publication
Combining all rural areas into one composite rate averages out these wide divergences and masks the reality that drug poisonings accounted for a large share of the widening rural mortality penalty in certain regions (e.g., Appalachia, New England) and economic contexts (e.g., mining counties) (Monnat, 2020b). Drug mortality rates increased throughout the entire study period for White males and females in all three age groups (Figure 7-1). Among Black males and females ages 25–44, rates remained relatively low and stable throughout the 1990s and 2000s, followed by an uptick in the 2010s. Rates increased among Black males and females ages 45–54 throughout the 1990s and early 2000s, then declined among Black males and leveled off among Black females during the mid-2000s before again increasing in the 2010s. Rates increased steadily throughout the study period among Black males and females ages 55–64 and then surged in the 2010s.
Annual Deaths Due to Alcohol, Drugs or Suicide Exceeded 156,000 According to the Most Recent Data
Using data from Norwegian Patient Registry (NPR) we investigated demographic characteristics, mortality, and physical and mental health comorbidities, among individuals with AIP or DT compared with AD patients. For some other cancer types, the panel found that elevated risks were most apparent at slightly greater levels of alcohol consumption. The risks of colorectal cancer increased above 30 g of ethanol per day (more than two US standard drinks), and liver cancer risks increased above 45 g per day (more than three US standard drinks). Lower levels of alcohol might still increase the risk of developing these cancers, but there wasn’t enough evidence to say. In the past few years, scientists have been zeroing in on the level of drinking at which cancer risk starts to rise.
