'Deaths of despair' hit record high in 2016

The number of so-called deaths of despair—deaths resulting from alcohol-related diseases, drugs, and suicides—in the United States  increased at a record pace of 11% between 2015 and 2016, according to a report published last week by Trust for America's Health (TFAH) and the Well Being Trust (WBT).

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For the report, which was supported by grants from WBT and the Robert Wood Johnson Foundation, researchers analyzed data from the National Center for Health Statistic's Multiple Cause of Death Files for 1999-2016.

Findings

Overall, the researchers found 142,000 U.S. residents died in 2016 from alcohol, drugs, or suicide. According to the report, the number of deaths attributed to alcohol, drugs, or suicide in 2016 is the highest number ever recorded, at an average of one death occurring every four minutes. 

Alcohol-related deaths

The researchers found the U.S. alcohol-related death rate trended upward from 2007 to 2016, increasing by an average of 4% annually. In total, the alcohol-related death rate increased by 40% from 2007 to 2016.

According to the report, 34,900 U.S. residents died from alcohol-related causes in 2016—representing a 5% increase between 2015 and 2016 from a rate of 10.3 deaths per 100,000 individuals in 2015 to a rate of 10.8 deaths per 100,000 individuals in 2016.

Drug-related deaths

The researchers found the rate of U.S. deaths related to synthetic opioids increased by more than 2,000% since 1999. According to the report, the rate of U.S. deaths related to synthetic opioids increased by 718% from 2007 to 2016. The researchers found U.S deaths attributed to synthetic opioids, including fentanyl and carfentanil, doubled from 9,600 in 2015 to 19,400 in 2016.

According to the report, the number of U.S. deaths attributed to synthetic opioids in 2016 for the first time surpassed the number of U.S. deaths related to heroin and the most common prescription opioids. The researchers found 15,500 U.S. residents died from heroin and 14,500 U.S. residents died from natural/semisynthetic opioids, such as codeine, in 2016.

Suicide deaths

The researchers found the U.S. suicide rate gradually increased from 2007 to 2016, rising by an average of 2% annually. In total, the U.S. suicide rate increased by 21% from 2007 to 2016.

The researchers found nearly 45,000 U.S. residents died from suicide in 2016. According to the report, the rate of U.S. suicide deaths increased from 13.7 deaths per 100,000 individuals in 2015 to 13.9 deaths per 100,000 individuals in 2016.

Disparities

The researchers found racial/ethnic and regional disparities in U.S. deaths attributed to alcohol, drugs, or suicide.

According to the report, drug-related deaths remained the highest among white U.S. residents in 2016. However, the research showed  there was a disproportionately large increase in the number of drug-related deaths among racial/ethnic minority groups, particularly among black U.S. residents, for whom drug-related deaths increased by 39% from 2015 to 2016. In comparison, drug-related deaths among Latino U.S. residents increased by 24% from 2015 to 2016, while such deaths increased by 19% among white U.S. residents over the same period. The researchers found suicide rates in 2016 increased more among blacks and Latinos than other demographic groups.

In terms of regional differences, the researchers found the Midwest and Northeast regions of the United States experienced the largest increases in alcohol, drug, or suicide deaths. In particular, Washington, D.C., and six states—Delaware, Illinois, Maryland, New Jersey, Ohio, and Pennsylvania—saw alcohol, drug, and suicide deaths increase by more than 20%.

Recommendations

The researchers wrote that their findings "reinforce the need for additional focus and funding at the national, state, and local levels to address the opioid epidemic and the underlying, long-term increases in alcohol, other drug, and suicide deaths."

The researchers recommended the United States develop a national strategy to comprehensively address deaths attributed to alcohol, drugs, and suicide by focusing on:

  • Early identification;
  • Effective treatments; and
  • Prevention.

In addition, the researchers said the United States should focus on:

  • Addressing the effect of the opioid misuse epidemic on children;
  • Expanding and modernizing mental health and substance use disorder treatment services;
  • Improving pain management and treatment;
  • Prioritizing prevention, reducing risk factors, and promoting resilience; and
  • Promoting responsible opioid prescribing practices.

Comments

John Auerbach, CEO and president of TFAH, said, "These new data demand policymakers rethink what communities are affected and what multisector strategies are needed to address these three epidemics. We must ensure that funding, programmatic efforts, and policies are directed to all the people and communities in need."

Ben Miller, a clinical psychologist at WBT, said, "When we talk about deaths from alcohol, drugs and suicide, we recognize that there is a relationship there—that we can't just look at the issue of suicide in isolation without tackling drugs and alcohol because the data show that they are related" (Zimmerman, Becker's Hospital Review, 2/23; Lardieri, U.S. News & World Report, 2/22; Fox, NBC News, 2/23; "Pain in the Nation" report, 2/22).

Learn more: How to combat the opioid epidemic

Opioid misuse and abuse is one of the most pressing public health issues in the U.S., and hospitals and health systems are on the front lines. Currently, most health systems focus their opioid management efforts on select medical specialties.

This report outlines three imperatives to guide hospitals and health systems in their efforts to reduce the impact of inappropriate opioid prescribing and misuse.

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