
2017 saw highest rate of death due to alcohol, drugs, suicide in US history [pdf] - vector_spaces
http://www.paininthenation.org/assets/pdfs/TFAH-2017-PainNationRpt.pdf
======
mr_luc
For me, the most useful page of the linked PDF is page 22, the tables of
1999-2015 stats, without any projections. I see numbers from the CDC for
general population like:

    
    
        Alcohol deaths per 100,000
        1999  2015  Pct Increase
        7.0   10.3  47%
    
        Drug deaths per 100,000
        1999  2015  Pct Increase
        6.9   16.3  136%
    
        Suicide deaths per 100,000
        1999  2015  Pct Increase
        10.5  13.8  31%
    

So, devil's avocado -- anecdotes aside, is this all just due to the opioid
epidemic?

Ie, the US is in the middle of a widespread opioid problem right now, and
suicide and alcohol use may correlate.

I would love to see some tables that compare this specific data across
multiple countries over the same time frame, as that could help tease apart
how much of this is really fallout from one single problem in the US, the
opioid crisis -- and, if not, what factors might be involved ('are there other
countries on a similar track? What do they have in common with the US?').

I wonder if OurWorldInData might be interested ...

Edit: others have posted the link below, with what might be 1 of the 6 sources
of data that would be helpful for this comparison: recent global suicide stats
by country. (Ideally we'd have this for all 3 causes, and then also for 1999).

[https://en.wikipedia.org/wiki/List_of_countries_by_suicide_r...](https://en.wikipedia.org/wiki/List_of_countries_by_suicide_rate)

~~~
rwmj
Relevant question: If someone dies and they have both alcohol and an opioid in
their bloodstream, do they count against alcohol, opioid, both, or do they try
to work out which one killed them?

~~~
nonbel
Funnily enough, I happened to be on the page that answers this.

Page 160: "Alcohol-induced deaths and drug-induced deaths are mutually-
exclusive. However, these deaths may also be considered suicide deaths."

Also, I can't find any more info on what is included here. They just say it
doesn't use ICD-10 codes:

>"NCHS has defined selected causes of death groups for analysis of all ages
mortality data: Drug-Induced causes, Alcohol-Induced Causes, All Other Causes.
The group code values are not actual ICD codes published in the International
Classification of Diseases, but are "recodes" defined to support analysis by
the Selected Causes of Death groups."
[https://wonder.cdc.gov/wonder/help/mcd.html#Drug/Alcohol%20I...](https://wonder.cdc.gov/wonder/help/mcd.html#Drug/Alcohol%20Induced%20Causes)

EDIT:

If I go to CDC WONDER
([https://wonder.cdc.gov/controller/datarequest/D76](https://wonder.cdc.gov/controller/datarequest/D76))
and click "Drug/alcohol induced causes" a box populates showing (presumably)
ICD-10 codes: X40-44, X60-64, X85, Y10-Y14

That includes stuff you wouldn't expect:

X44:

    
    
      agents primarily acting on smooth and skeletal muscles and the respiratory system
      anaesthetics (general)(local)
      drugs affecting the:
      · cardiovascular system
      · gastrointestinal system
      hormones and synthetic substitutes
      systemic and haematological agents
      systemic antibiotics and other anti-infectives
      therapeutic gases
      topical preparations
      vaccines
      water-balance agents and drugs affecting mineral and uric acid metabolism 

[http://apps.who.int/classifications/apps/icd/icd10online2004...](http://apps.who.int/classifications/apps/icd/icd10online2004/fr-
icd.htm?gx40.htm+)

So this could be partially due to "better access to healthcare". More people
are being put on blood pressure, etc medications and are dying from
over/under-dosing on them. I don't see any reason for them to include X44 in
the current study besides trying to mess with the numbers...

EDIT 2:

Indeed, when I selected only x44 on CDC WONDER, here are the results:

    
    
      Year Deaths per 100k Pop
      1999  1.5
      2000  1.7
      2001  1.9
      2002  2.4
      2003  2.6
      2004  2.9
      2005  3.3
      2006  3.8
      2007  4.2
      2008  4.5
      2009  4.7
      2010  5.0
      2011  5.6
      2012  5.3
      2013  5.5
      2014  5.8
      2015  6.3
      2016  7.4
      2017  8.1
    

So the death rate from normal (not addictive or recreational) medications is
5.4x higher in 2017 than in 1999.

~~~
syn0byte
Muscle relaxers, certain types of steroids, GHB, NO2, and even cocaine are all
technically part of that list.

Your not wrong, but it's not that super clear cut either.

~~~
nonbel
Yes, they are grouping together the (lets call them) "DARE drugs" with
"medical drugs".

Presumably this is strategic to hide whatever issue is going on with the
"medical drugs" and inflate the apparent problem with "DARE drugs".

------
lm28469
People feeling left aside by society always find a way out, it's more of a
systemic issue than an alcohol or drug one.

I guess having a for profit health industry trying to prescribe as much opioid
as possible doesn't help.

As long as we keep putting the blame on individuals* and not on the system
they live in we're doomed to fail. Putting tax on alcohol, war on drugs and
banning beer sales on Sunday aren't going to fix any of the underlying
problems.

* which is very easy and relieving, after all I don't have to do anything if that's just how people are.

~~~
mc32
Perhaps. It’s not a simple issue though. Thoroughly affluent kids get hooked.
Affluent parents get hooked. Runaways get hooked, homeless get hooked. Working
poor get hooked.

It’s more than “society sucks.” If it really sucked people would be escaping
our borders going to Mexico and Canada in droves but it’s the opposite.

If a Mexican citizen is worse off on average than an American, why are
Mexicans never the less less impacted by this kind of epidemic?

What do people in depressed areas of Japan do, do they fall for this, why or
why not?

~~~
justaguyhere
* It’s not a simple issue though. Thoroughly affluent kids get hooked. Affluent parents get hooked.*

Didn't some affluent, highly educated guys go to Syria to join terrorists?
Anyone can feel left out, ignored - even the wealthy and educated people.
Maybe the breakdown of family structures, not having good
friendships/relationships, loneliness contribute to these problems? People
long to be a part of something- when that doesn't happen, they numb themselves
with drugs, join criminal gangs etc.

This is not something that can be fixed by passing some laws or demonizing the
affected people, it requires a more empathetic approach than use of force or
law.

~~~
mc32
I think it’s something very much societal. In Japan or China, Vietnam, etc.,
drug use is almost always seen in a negative light. It’s not about sowing wild
oats, having forbidden fun, an outlet for hardship, etc. They’re always
denigrated in all media, in society, in school, in music, films, at work, etc.
It’s never any kind of cool in any way. It’s shunned ostracized outlawed and
unaccepted. Does that map well to our society? I’m afraid not much. We’ll have
to find another way out.

------
pixelpoet
Once again, alcohol listed separately from "drugs", and it's the most harmful
drug of the lot.

Can we even be surprised that alcoholism is such a problem when we cannot even
recognise as a society that it's actually a drug?

~~~
vonmoltke
Alcohol's dangers get whitewashed frequently, but they don't hold a candle to
the likes ketamine, crack cocaine, and methamphetamine.

~~~
JBReefer
What's wrong with Ketamine? It's not particularly addictive, and it's worst
side effect is kidney damage (which can be quite severe). Are you sure you
don't mean Heroin or Fentanyl? Those are the worst of the bunch.

------
DJBunnies
It was touch and go there for a while, but I'm happy to have avoided
contributing to those statistics.

Every day is a gift, folks.

~~~
ComputerGuru
Glad you're still with us! Surround yourself with people you can talk to.

------
triviatise
Despair is the absence of hope. People have been given an unrealistic view of
what life should be and when it is so much worse than their expectations they
fall into despair.

The media hurts because we are exposed to the "lifestyles of the rich and
famous". Im gen X which seems to have the suicide problem. Gen X was raised
with "greed is good" and glamorized miami vice. That is a hollow empty promise
even when fulfilled.

I think another of the key problems is a lack of life philosophy
(spirituality?) where people can find meaning in their lives outside of
material goods. This is partially due to the death of religion. There also is
a lack of understanding that life is fundamentally unfair and there somehow is
the expectation that it should be fair. Without religion people are missing a
clear moral compass that guides their life to find meaning. There needs to be
a new modern philosophy that has moral underpinnings, but incorporates
science, without necessarily having a deity.

Finally, children (including my generation) have been sheltered from lifes
daily challenges by being given too much. I suspect when they become adults
they simply can't handle what their lives actually are.

I think the current generation of kids are being raised to try to change the
world and to seek meaning in helping other people. However they are also being
raised to think that life should be fair and they are going to be bitterly
disappointed.

~~~
airza
The material conditions of life have been _annihilated_ in the areas that have
been ravaged by the opioid epidemic. My brother died of a drug overdose on one
of them, and it wasn't because of a lack of moral underpinning. It was because
almost nobody who is born and grows up in one will ever have a chance of a
stable life. No steady access to income, healthcare or a chance of escaping
the working class. Hoping for the chance to lead a stable middle class life
isn't a _moral failing_.

~~~
triviatise
Im sorry about your brother.

I never said it was a moral failing. What I did say is that people lack a
values system to find meaning in their life. Even if you are poor, you can
find meaning in your life, yet our society is completely geared around
material goods= meaning. Religion used to fill that role.

That hole is often times filled with meaningless partying that can include
experimentation with drugs. Of course many people get addicted via actual
prescriptions. I havent done much research, but the article below suggests
that few people are getting addicted via prescriptions.

why do people start using opioids in the first place?

[https://tonic.vice.com/en_us/article/a3z98b/big-pharma-
didnt...](https://tonic.vice.com/en_us/article/a3z98b/big-pharma-didnt-cause-
the-opioid-crisis-most-pain-patients-dont-get-addicted)

<<The research actually shows that people who developed new addictions in
recent years were overwhelmingly not pain patients. Instead, they were mainly
friends, relatives, and others to whom those pills were diverted—typically
young people. Among the older patients, many who appeared to be newly addicted
had actually relapsed or never recovered from prior addictions: some faked
pain to get pills from well-meaning doctors; others got them from pill mills
where shady physicians wrote prescriptions for cash.>>

------
LUmBULtERA
I have always wondered, what is our life expectancy if we removed all deaths
of despair from the statistics? This is a little different than the delta from
the change in the deaths of despair (e.g., the report does say that our life
expectancy is decreasing because of the deaths, but I didn't see the total
impact of all of them on the stat). If I know I'm not going to die because of
a death of despair, how long should I expect to live?

~~~
grenoire
How can you know that? Serious question.

~~~
LUmBULtERA
How can I know I won't commit suicide, die via an overdose, or another kind of
death of despair? As far as I'm aware, these are still choices for most of us.
So if I choose to not die a death of despair, what would my life expectancy
be?

~~~
vonmoltke
For starters, why is your assumption that every overdose death is a "death of
despair"? Are you assuming that only people in despair use recreational drugs?
Neither of those sounds reasonable to me.

~~~
LUmBULtERA
I'm using the terminology from the report.

------
arandr0x
You can actually acutely treat opioid overdose (with antagonists) and so
presumably the actual issue here is people use drugs alone in locations where
nobody is going to check on them for something like an hour. There may be an
education campaign there so that people prescribed painkillers know to never
use them alone.

Also, we probably need to invest in lifestyle education for preventing
depression like we do for preventing obesity. Have campaigns asking people if
they've had one pleasant conversation today. Force workplaces to give people a
midday break where they are allowed to leave the facility in winter. Sensitize
parents to symptoms of their child developing persistent anxiety or sadness
like they are to the height/weight curves. (Also, develop ways of treating
mild depression that aren't SSRIs -- light therapy, animals, caffeine, sleep
deprivation, whatever, but a ton of people are refusing to seek help because
they don't want meds that they see as having too many problematic side
effects.)

------
boomboomsubban
Maybe I'm missing something, but your source seems to only have data for
99-2015, and references a projection study done by the Berkeley Research
Group.

------
odiroot
The most interesting part of this report is the huge difference between the
numbers for men and women.

Are there any programs in the US helping solve this enormous divide?

------
nakedrobot2
This is the hundredth nub of a massive problem of the regression and
deterioration of society in the usa. Yes, opiates. Yes, for profit health
care. But even those things in isolation are only part of the problem.

------
YinglingLight
Keep going after fentanyl. It's poisoning us.

~~~
RankingMember
Fentanyl is dangerous, sure, but until we address the root issues that cause
people to take up opiods in the first place (over-prescription, sometimes, but
certainly also hopelessness and mental health issues), it'll be an endless
game of whack-a-mole.

I think the most cost-effective thing we could do right now to reduce fentanyl
deaths is offer test kits free in pharmacies across the country. Anecdotally,
the majority of fentanyl deaths I hear of are from people who think they're
shooting heroin and don't realize their dope is laced with fentanyl.

~~~
jgowdy
No offense, but do you honestly believe most heroin users are going to buy a
test kit to test their drugs and then if it tests positive not use them? The
practical value of those test kits seems low to me, as I don't believe they
would be heavily used and I don't believe that many herion users wouldn't
continue in the fact of a positive test.

~~~
RankingMember
No, I really don't- that's why I think it's important that it'd be free. Not
every heroin user is under a bridge shooting up with dirty needles; they
actually go and buy/exchange clean needles believe it or not. I don't think
it's a big jump from there to testing your junk so you can keep your addiction
on the down-low rather than having a family member find you blue one evening.

------
swiley
If you isolate everyone the way the modern world does this shouldn’t be
surprising.

------
En_gr_Student
I have an outstanding hypothesis that suggests that even if the opoid epidemic
went totally away tomorrow, this is not the steepest increase, and the
increase will continue for the next 20 years.

The suicide rate should bump itself up substantially above 50 per 100k,
especially for younger demographics. It should then plateau for the
foreseeable future.

I really really really really hope that I am wrong. We have folks with no
vision in charge, and they drove a big ship into the rocks: my hypothesis is
that this is onset/ramp-up of body count.

------
lorinm
I wonder what is the impact of social media in this rate increase. People are
getting more and more addicted to it, thus making people more depressed about
their lives which in turn find their relief in drugs and alcohol. I am not
saying that social media is to blame for everything but as a former heavy user
of Snapchat and Instagram, it must be up there as one of the main causes. The
sad and hopeless part is that its all by design...

~~~
DanBC
Social media is also an important way to connect for people who are socially
isolated, so we should avoid demonising it.

We need to worry about promotion of self harm and suicide being distributed on
social media, but most companies are taking action on the worst content.

------
mrhappyunhappy
Let me guess, isolation - both social and physical, brought about by cell
phones and social media cancer is making people lonely and depressed. They
turn to alcohol but that doesn’t quite do it so they turn to opioids and then
decide to take their life. Perhaps I’m just pulling on unrelated strings to
make a rope, or perhaps there is some truth to it?

~~~
1auralynn
Social media and cell phones are the partial solution to the isolation brought
about by the way we design our communities - sprawl, no town centers, etc.
Also, drunk driving becoming more penalized (rightly so) so less gathering in
bars, people becoming less religious. Isolation is the cause of the rise of
social media, not the opposite, in my opinion.

~~~
mrhappyunhappy
It’s peobably both, cause and effect. I agree with everything else you said.
It’s just hard not to be depressed when I see everyone staring at their phone.
I imagine back in the day people would strike up conversations and make random
friends. Can anyone who was an adult pre-phones confirm this? There is no
reason to make conversations with strangers anymore as anything you read
online is likely more interesting and you can “pause” any time. I am guilty
myself, and have to remind myself constantly that there is more to being in
public than hiding behind a screen. Maybe I’m the weirdo who occasionally
makes too much eye contact.

------
nonbel
I wanted to see what ICD-10 codes they used for "drugs" since I have seen
similar claims before that grouped in "drug" over/under-doses in a general
sense. Ie, it included stuff like deaths from blood pressure medications.

I was disappointed to find that the "source" was apparently a (no longer
found) Washington Post article:

> _" The United States is facing a new set of epidemics — more than 1 million
> Americans have died in the past decade from drug overdoses, alcohol and
> suicides (2006 to 2015).1"_

1 Hohmann J. “The Daily 202: Trump over performed the most in counties with
the highest drug, alcohol and suicide mortality rates.” Washington Post
December 9, 2016.
[https://www.washingtonpost.com/news/](https://www.washingtonpost.com/news/)
powerpost/paloma/daily-202/2016/12/09/ daily-202-trump-over-performed-the-
most- in-counties-with-the-highest-drug-alcohol- and-suicide-mortality-
rates/584a2a59e9b- 69b7e58e45f2e/?utm_term=.d3109d2f4877 (accessed September
2017).

I have trouble taking this document seriously after that.

~~~
mr_luc
Per Appendix B, the source of the data is the CDC's Wonder "multiple cause of
death" data, which does include the codes you mention:

[https://wonder.cdc.gov/mcd-icd10.html](https://wonder.cdc.gov/mcd-icd10.html)

"... The Multiple Cause of Death database contains mortality and population
counts for all U.S. counties. Data are based on death certificates for U.S.
residents. Each death certificate contains a single underlying cause of death,
up to twenty additional multiple causes, and demographic data. The number of
deaths, crude death rates, age-adjusted death rates and 95% confidence
intervals for death rates can be obtained by cause of death (4 digit ICD-10
codes, 113 selected causes of death, 130 selected causes of infant death, drug
and alcohol related causes of death, injury intent and injury mechanism
categories) ..."

The fact that a study-cum-policy-paper happens to also cite reporting on the
problem is par for the course.

------
gambler
Why is the title title phrased as if 2017 was special, when most of the
previous years also seen highest death rates from those causes? A lot of
charts in the paper end at 2015.

------
nickthemagicman
This is a real National Emergency.

------
JoeAltmaier
Maybe its just technology.

[https://www.statista.com/statistics/971676/online-alcohol-
sa...](https://www.statista.com/statistics/971676/online-alcohol-sales-growth-
us/)

------
redleggedfrog
I hate to say this, but we brought this on ourselves. It's just one aspect of
the decline of America.

At one time, we could identify with, "Land of the free, home of the brave." I
remember my Grandpa, saying that to me, and then telling me, "So kid, stay
free, and be brave about it. I did my best, and when you grow up, do yours,
right? You're an American." Of course, I'm like 10 and know nothing of the
world, but I honest felt like I was part of a greater thing, that I was now
going to be following in the footsteps of Grandpa.

Then I grow up, and America slowly gives away her freedoms. Not just personal
freedom, but the freedom to excel. The middle class slowly fades, education
becomes prohibitively expensive. Upward mobility wanes.

Then 911 happens and America loses it's shit. We're shown to just be a bunch
of pansies. We react by becoming a (worse) global bully, frightened and trying
to control the uncontrollable. And we trade freedom for perceived safety. Ever
think the Patriot Act will be allowed to expire?

Then of course we get the perfect to represent the coward bully that is now
all of us.

And oh boy do we like our guns and drugs. Now that's the new America. That's
our refuge. More guns, and more drugs. We suck down so many drugs that the
rest of the world works really hard to keep us supplied. We work hard to keep
us supplied (Afghanistan).

And then lastly, we isolate ourselves, unable to make friends, interacting
over the internet instead of in person. We shape our world and ideas with
constant confirmation bias. We work hard to reinforce our prejudices. Nation
of tribal haters. The charade of Democrat and Republican and Ford vs. Chevy
and Cowboys vs Patriots. Choose a side, get angry, espouse.

So what's left in an America like that for a man? Sure, it affects women to,
much the same, but as a man I particularly feel it. This ain't my America, the
one I read about from our past. It's seriously depressing.

This might seem like pining for the old days. "Things are better than ever
now!" you say. So, really? Why are people opting out in record numbers then?

~~~
triviatise
None of those things should have any impact on your daily life. If you didnt
plug into the internet (your choice) you wouldnt know about any of those
things and they simply wouldnt matter.

I live in the same country and I have a great life based on the actual people
around me, not based on news media that pulls the worst things from around the
country to try to generate more clicks.

~~~
jumpman500
You think it's possible to unplug from the internet? All you have to do is to
talk to one living person in America to feel the cultural impact of social
media and the internet. There is no unplugging. Unless you go start a commune
in the middle of no where. You can't just turn this off, it's in every aspect
of our society. I agree putting yourself on a media diet is a good thing, but
my diet isn't going to get my friends in shape.

~~~
ryandrake
Sure, it’s possible and plenty of people do turn it off or minimize use.
Internet use is voluntary, and one can choose their level of use/interaction
with it. Try it for a week! Unplug and just live your life.

I’ve always thought one of the few real extraordinary strengths of the USA
culturally is the extent to which “going off grid” is acceptable. If you want
to, you can live a fine life without social media, Netflix, and cable TV. If
you want, you can move to the middle of nowhere, dig a well and put up solar
panels. You can homeschool your kids. You can hunt your own food. Not all of
these things require lots of money. Compared to many places in the developed
world, by and large you have an extraordinary ability to choose your own level
of societal interdependence.

~~~
jumpman500
Yea I agree. You can definitely disconnect completely from society. I've been
off social media for a while and don't really follow much outrage media. But
you can't tell your friends and family what to do. They can still have an
unhealthy fixation on the latest media/culture war and unless you disconnect
from those people it will become a part of your life. Technically you can
always be a hermit. I just don't find that a very appealing choice.

------
tha_nose
About 1.9 million deaths in the US. About 45K or 2% of those are suicides.

[https://www.cdc.gov/nchs/fastats/deaths.htm](https://www.cdc.gov/nchs/fastats/deaths.htm)

And people here are saying that is the national emergency?

The US is nowhere near the top in terms of suicide rates in the world.

[https://en.wikipedia.org/wiki/List_of_countries_by_suicide_r...](https://en.wikipedia.org/wiki/List_of_countries_by_suicide_rate)

If we really wanted to help people, we'd focus more on heart disease,
diabetes, etc. But I guess we don't want to tackle the food industry, soda
industry, process food industry, etc.

I don't who is behind all the "alcohol, drugs, suicide" scaremongering. But I
have a sneaking suspicion that the "solution" will be pump people with more
pharmaceuticals.

I'm not saying suicide is not a terrible thing, but it certainly isn't a
"national emergency" compared to heart disease, strokes, cancer or diabetes.

~~~
mbostleman
It's about what's trending. Recent stats on US life expectancy showed an
overall drop. Heart disease and (I think) cancer trended down (as it has for
years), but that was more than offset by the up trend in suicide and
overdoses. I'm not sure what the definition of "emergency" is, but I'd say the
data shows suicide and OD are the top concerns at the moment.

~~~
tha_nose
The data clearly doesn't not say what you claim. As for trending? I wouldn't
call anything going from 1.9% of deaths to 2% of deaths as trending. Focusing
on the 2% rather than the 98% seems also doesn't seem to be sensible.

~~~
tdfx
OP is saying the rate of change is cause for alarm, not the overall
distribution.

------
zenpaul
And in other news, "2017 saw largest total population in US history".

How about "2017 saw highest increase in death due to alcohol, drugs and
suicide in US history"?

~~~
darrenf
I'm not sure what population has to do with it. The headline and the PDF
itself talk about the _rate_ of death — the text refers to deaths per 100,000
throughout.

------
rygxqpbsngav
I suspect it might rise more. With a culture that predominantly revolves
around party/fun culture where you drink alcohol and consume drugs, when youth
of other cultures are busy planning their life and studies & career, where
youth in U.S. is more inclined towards partying and porn and care free
lifestyle; No wonder the numbers might rise.

~~~
LUmBULtERA
Pardon? The highest increases in suicide and overdoses is in the 45-54 year
old demographic (see page 23).

