In 2016, 142,000 Americans died as a result of alcohol, drugs, or suicide, according to the latest government data.
This is the largest number ever recorded for these so-called “deaths of despair” and an 11 percent increase since 2015.
This means that on average, one American dies every four minutes from drugs, alcohol, or suicide.
These findings from the Centers for Disease Control and Prevention (CDC) are highlighted in a report by the nonprofit Trust for America’s Health.
Previous studies focused on the impact of deaths from alcohol, drugs, and suicide on white non-Hispanic middle-aged Americans.
The latest CDC data report shows that white Americans still have the highest rates of deaths from each of these.
But other racial/ethnic and age groups are now seeing an increasing number of deaths, especially from drug overdoses.
“It’s clearly a phenomenon that’s affecting all populations at this point,” said Dr. Ana Diez Roux, dean and professor of epidemiology in the Dornsife School of Public Health at Drexel University in Pennsylvania.
In 2016, the 67,300 drug-related deaths accounted for almost half of the deaths of despair.
Death rates continued to be highest among whites, men, 35-year-olds to 54-year-olds, and people living in the Northeast.
Over the past decade, the overall drug death rate increased 63 percent, with larger annual increases after 2012.
Minorities still have lower rates than whites, but drug deaths increased 39 percent among African Americans and 24 percent among Hispanics between 2015 and 2016.
“The fact that there’s this uptick in drug-related deaths, and that it’s been consistent across several years and now seems to have extended into other population groups, is a very worrisome public health observation,” Diez Roux told Healthline.
The alcohol death rate also increased over the past decade — about 5 percent per year.
In 2016, alcohol deaths were highest among men, whites, 55-year-olds to 64-year-olds, and people from Western states.
Between 2015 and 2016, young adults, Midwesterners, and people living in nonmetro areas saw the largest increases in deaths due to alcohol.
Suicide deaths also remain high — almost 45,000 in 2016. This is more than car-related fatalities.
Over the past decade, the suicide death rate has increased 21 percent, or about 2 percent each year.
The rates are highest among men, whites, 35-year-olds to 54-year-olds, and those over age 75 years.
Prescription opioids driving drug deaths
Many experts think the driving force behind recent increases in drug-related deaths is overdoses from synthetic opioids such as fentanyl and carfentanil.
Deaths from synthetic opioids doubled between 2015 and 2016 — from 9,600 to 19,400. They also surpassed the number of deaths related to heroin and the most common prescription opioids.
The spike in deaths is partly due to the dangerous quality of synthetic opioids. Fentanyl is 50 times more potent than heroin. Carfentanil is 10,000 times more potent than morphine, according to the Drug Enforcement Agency (DEA).
Most segments of society saw large increases in deaths from fentanyl and other synthetic opioids — both sexes, most adult age groups, and all racial and ethnic groups.
Earlier reports focused on opioid deaths in rural areas, but the latest data shows that deaths from synthetic opioids increased in both rural and urban areas.
Much attention has been paid to the role of overprescribing in the opioid epidemic.
“Some of this, particularly the opioid-related deaths, has been triggered and reinforced by prescribing patterns for pain medications, which has led to overuse of these drugs and addiction,” said Diez Roux.
People who become addicted to prescription opioids, even those used as prescribed, may move onto abusing other kinds of opioids or drugs.
But Diez Roux said that the increase in deaths of despair are “probably a combination of factors — some more distal, such as social and economic conditions in many of these communities, and expectations about the future.”
It is these social factors, particularly loss of hope about future job prospects or quality of life, which led to these being referred to as “deaths of despair.”
“The media and politicians have focused quite a bit on opioids, but as this report shows, our problem is much bigger than opioids,” said Shannon Monnat, PhD, an associate professor of sociology at Syracuse University in New York.
“We are not going to Narcan our way out of it,” she added, referring to the opioid overdose medication naloxone. “Opioids are a symptom of much larger social and economic problems.”
She pointed to economic factors such as rising income inequality, stagnant real wages for many workers, and fewer jobs with benefits.
But other factors may also be involved.
“Economic decline is certainly an important factor, but our drug, alcohol, and suicide problem is also related to social decline,” Monnat told Healthline. “We live in an era of individualism, disinvestment in social safety nets, declines in social cohesion, and increased loneliness.”
Stopping deaths of despair
Many efforts to decrease the number of deaths of despair have focused on drug deaths, particularly those related to opioids.
The Trump administration declared the opioid epidemic a national emergency last fall, but the federal government’s response is still taking shape.
States and pharmacies are also tackling overprescribing by setting limits on how many pills doctors can prescribe at a time, and setting up databases that identify people who may be “doctor shopping” for prescription opioids.
Many health experts have also called for an increase in mental health funding, especially treatment programs for opioid and other drug addictions.
“In order to address this,” said Diez Roux, “we need to do things to help people who are addicted, or who are having mental health issues as a result of addiction or independently of that.”
The Trust for America’s Health calls for the creation of a “National Resilience Strategy” that includes approaches such as finding better ways to treat pain that lower the risk of addiction and a “full-scale approach” to the opioid crisis.
Monnat thinks that the underlying social problems also need to be addressed because even if we get opioids under control, a new drug crisis may emerge in the future.
This includes creating livable wage jobs for people without college degrees, restructuring the tax system to benefit all Americans, and investing in our communities.
“Combating today’s opioid epidemic — and tomorrow’s new drug epidemic — involves all of us reflecting on what kind of society we want,” said Monnat.