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%
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).
Speaking of philosophy I also have seen claims that the damage that is done to the environment would feed back into the social fabric - so people would kind of feel the tension from the damage that is done to nature. I was unable to find anything that could corroborate these claims nor do I subscribe to it, but fwiw the thought has stuck with me. (my interpretation of it is that many people today are hooked to some form of news on social media which is mostly negative. When I grew up news seem to be something only old people read now everyone is engaged in the problems of far away issues. Or maybe it's because I'm old myself now in comparison and am more prone to consuming news with all its negativity ...)
Suicide can be described like any other disease . It has a coefficient of communicability/spread. Though I can't find the citation, it is thought that social media has increased this coefficient by ~22x ; meaning that suicide has become much easier to 'catch'. In the US, a fair few suicide 'clusters' have sprung up and many more are likely being hidden by empathetic, yet mis-guided, coroners. One famous one was in at Palo Alto HS in California, where a lot of Stanford's Professors sent their kids. Another, still ongoing, is in Colorado Springs' religious High School network. I'll let Newsweek speak for the true horror that is possible via new technology:
>“This is the part that kills me—I know she was texting other kids at the time and letting them know,” he says. She wrote, “My feet are off the floor,” and “Everything is getting hazy and dark.” None of the kids intervened; one responded by suggesting she “unhang.”
Suicide is also prevalent in east Africa currently  and there have been spats of it throughout time in a wide variety of place and for a large range of reasons.
Even talking about suicide at all, like I am currently doing, can increase it's reach. It's a very tricky thing to research and combat, as a consequence.
PLEASE, if you are feeling suicidal, reach out! Call a friend, a family member, or someone you feel safe with. CALL THIS NUMBER NOW:
 Like describing a stuffy nose; it has many causes.
Forensic toxicology screens are pretty thorough, and benefit from being able to take invasive samples like heart blood, brain, liver, and even eye tissue samples. That provides a lot of flexibility to find any substance that's present and look at relative concentrations and metabolites. Toxicology is usually sufficient in combination with the coroner's report on proximate cause of death; even if multiple substances are found, it's only a problem if they're all able to kill by the relevant mechanism.
In this example, someone with a high alcohol tolerance might die with a potentially-lethal level of alcohol in their blood, and also test positive for opioids. A tox screen should then be able to estimate that they had stopped drinking a few hours before (e.g. high acetaldehyde levels in blood and urine, no alcohol in stomach fluids), then freshly used opioids just before the time of death.
This gets harder if you have drugs with additive effects (e.g. death by respiratory depression, testing positive for heroin and ketamine); the autopsy would list both, but I don't know how the stats are handled. And it seems like a nightmare in the case of drug interactions; I have no idea what happens if somebody dies of serotonin syndrome triggered by mixing alcohol with MAOIs.
"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...
If I go to CDC WONDER (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:
agents primarily acting on smooth and skeletal muscles and the respiratory system
drugs affecting the:
· cardiovascular system
· gastrointestinal system
hormones and synthetic substitutes
systemic and haematological agents
systemic antibiotics and other anti-infectives
water-balance agents and drugs affecting mineral and uric acid metabolism
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...
Indeed, when I selected only x44 on CDC WONDER, here are the results:
Year Deaths per 100k Pop
ICD coding features both an underlying cause of death, the X40-X44 range you're checking, and a "contributing cause" code which attempts to specify the substance involved. In this case, that's the T40.0-T40.6 range. The government guidelines on using WONDER to study opioids include "Please note: X and Y codes must be used in combination with T codes to identify opioid-related deaths."
That's because X42 only covers certain narcotic opioids like heroin, so an X44 opioid overdose is a possibility. Since that's "Accidental poisoning by and exposure to other and unspecified drugs", it could accompany T40.2 ("other opioids") or T40.6 ("unspecified narcotics"). And if the coroner doesn't record anything beyond "accidental drug overdose", then even heroin overdoses will result in X44, T50.9 ("unspecified drugs"). That last case alone apparently describes 25% of all US overdoses.
There's no slight of hand here, just a confusing two-layered classification system.
edit: here's a CDC page listing which primary and contributing causes can go together. Both prescription and illicit opioid deaths can be be filed as X44. https://www.cdc.gov/drugoverdose/pdf/pdo_guide_to_icd-9-cm_a...
That said, I think the specific rationale is that X44 is meant to hold all types of low-frequency poisoning by drugs, and 'unknown drug' usually means "not one of the notable drugs that gets its own code and is tested for". This usually works alright. X45-X49 handle cases like "alcohol poisoning", "tainted food", "inhaled chlorine fumes", and "other/unspecified chemicals", so X44 is only representing drugs. And "poisoning" is separate from "adverse effects" (Y40-Y84), so an allergic reaction or a standard risk like bleeding from warfarin won't get mixed in here. Given that, X44 is just a reasonably narrow category to assign a group of T## codes to. Those go into enormous detail, and have secondary "unknown" categories to handle the case where you know the class of drug but not the specific drug. Totally unknown poisonings are restricted to X44/T50.9 and should be extremely rare.
But this was all designed by 1990; it looked reasonable to divide both X and T categories by "non-opioid analgesic", "anesthetics", and "narcotics". It wasn't until we started widely prescribing strong opioids for pain that "painkillers plus heroin" became a key grouping you'd want to research. That, plus the international nature of the system, also left us with "heroin", "opium", and "other opioids" as the only 3 T codes for this topic. The listed examples for 'other' are morphine and its prodrug codeine; as a result we've got fentanyl and morphine in the same category despite a 100x difference in strength.
Compounding that, the narcotic poisoning (X42/T40) grouping was basically doomed from the beginning through no fault of the designers. It tries to replicate the legal/treaty category of narcotics, which has no biological coherence; what on earth do cocaine and morphine overdose have in common? Why is "cannabis derivative poisoning" singled out in the 'narcotics' section of a document created when the only synthetic cannabinoid in use was a rare antiemetic no one abused?
tl;dr: It was supposed to be a low-frequency grouping with subcategories clarifying about specific drugs, but that fell apart for opioids.
Your not wrong, but it's not that super clear cut either.
Presumably this is strategic to hide whatever issue is going on with the "medical drugs" and inflate the apparent problem with "DARE drugs".
X42 governs accidental narcotic poisoning, but only in cases where the drug is specified, and isn't necessarily applied for prescription opioids. The list above for X44 is the 'including' list of suggestions, but the category includes any death from "unspecified drugs". And contributing causes of death are handled under a separate system making it possible to list more drugs in more detail, so the CDC says that both prescription and illicit opioid deaths can crop up under X44.
Yes, they put their best medical experts to the task...
I see that some of the data is labeled "per 100,000 individuals," not deaths.
Obviously, there is a specific policy push and point of view outlined in the paper, which is probably why most such papers are published.
But a lot of this data is from the CDC and should be independently verifiable and from Appendix B of the paper, I see that the ultimate source is something called "CDC Wonder".
And it looks like one can make a request for that data:
I suppose there is some replacement effect in here, where if fewer people die in car crashes they're more likely to live long enough to die of Alzheimers. That's part of why the death rate has been climbing; the population is aging overall. To handle that, there are also "age-adjusted" death rates available, which standardize years of life lost. That can be a big difference; for instance the UK suicide rate is much lower than the US one, but also skews much younger so the age-adjusted rates are closer.
snipped to imgur: https://i.imgur.com/yLTwL3J.png
Edit: my original comment may have implied that I was minimizing the importance of the issue, which I hope wasn't the impression I gave -- it's striking that the only good news whatsoever is a small reduction in alcohol deaths among black people, which was canceled out and then some in drug deaths.
It's really difficult to compare suicide rates across countries, especially across time, because how they count suicide is different in different countries and changes across time.
Tracking these three causes together would probably help as well; if one culture is biased towards over-counting overdoses, for instance, and under-counting suicides (which makes me think of the Ray Bradbury line, that someone had "jumped off a pill bottle"), tracking stats for a few proximate causes probably helps get a better overall picture.
I had occasion to look into this one recently, actually. In the UK, for example, undetermined-intent drug and injury deaths among adults are included in suicide statistics by default. (That's based largely on the logic that intent is hard to show and false positives are quite painful, while determination of an accident is comparatively easy and harmless.) The US doesn't include those deaths as suicides, but with standardized ICD codes we can easily recover the data. Adding them in raises the US suicide rate about 11%.
Demography is also available, and pretty significant. The US suicide spike is overwhelmingly in adults, so while the US suicide rate is 66% higher than the UK (without definition correction), the age-adjusted death rate is 40% higher.
And you're right about the mixed causes, too. There are probably a nontrivial number of suicides which are explicitly ruled 'accidental', but stats like "overdoses plus suicides" do a lot of work correcting for that. Even for laypeople it's enough to start with, and then actual researchers of course go into specific data on traffic deaths, drownings, and so on.
For one example - the burden of proof used by coroners changed in 2018. This means it's going to be a bit tricky to compare deaths before and after this date, and there's going to be variation as this information is applied by coroners as they get used to the new level.
And the coroners numbers do affect the ONS data.
The ONS describe the difficulties of comparing data across nations here: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...
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.
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?
Some very poor workers enjoy their craft and are 100% fulfilled by it, some very rich celebrities lost themselves in their money and fame. I tend to think that having a community has more importance than money in that regard.
People survived in the past by working 12+ hours a day 7 days a week, but they had strong family bond (someone sick wouldn't get paid, no welfare, no pension, &c ..).
If anything (too much) money enables you to go down the rabbit hole and amplify your vices.
And another claim - if they knew, and moving would be painless easy cheap weekend effort, you would see much of US population move out someplace better, mainly those with lower incomes.
Its really THAT different. Less pressure for monetary success and pressures in general, much less crime, system generally helps you much more when you hit the bottom, healthcare is a topic on its own and so on. US used to be great place although never easy. Then it got OK. Now, if I would be moving, I would consider every single continent, including Antarctica as new home rather than US. And I am stating this as a person who in every country I lived so far belonged in say top 5% earners in population, and I would be a very much OK in US too.
(1) The prevalence of drug overdose deaths and opioid prescriptions has risen unevenly across the county, with rural areas more heavily affected. Specific geographic areas, such as Appalachia, parts of the West and the Midwest, and New England, have seen higher prevalence than other areas.
(2) Poverty, unemployment rates, and the employment-to-population ratio are highly correlated with the prevalence of prescription opioids and with substance use measures. On average, counties with worse economic prospects are more likely to have higher rates of opioid prescriptions, opioid-related hospitalizations, and drug overdose deaths.
(3) Some high-poverty regions of the country were relatively isolated from the opioid epidemic, as shown by our substance use measures, as of 2016.
Still as 3 can attest and as you said, it isn’t simple.
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.
This is a disturbing way to think about people. The state should not be in the business of saving people from themselves, least of all with a deeply regressive tax.
What should the state be in the business of exactly? It's in the business of defending people from other people. You could frame it as "saving people from themselves" or you could justifiably frame it as "saving people from companies seeking to poison them".
Also, the state has account for these people in the form of emergency care and treatment when they kill themselves (and often times others on their way out). These people are unfairly burdening the tax base when they decide to kill themselves in a spectacular flaming car crash, so why doesn't it make sense for the state to protect the interests of the group as a whole?
Alcohol related deaths are the 3rd highest preventable form of death in the US. It's great that you can responsibly enjoy an IPA with your friends. Pretending it's only fun and good times on the larger scale is naive at best.
It is not your right to choose what others do with their life. When it's abortion, some people are all "her body, her choice!", and when it's alcohol or cigarettes, it's "her body, our choice!".
Why do you think the sanctity of somebody's own life is yours to weigh against the risks of alcoholism or a tobacco habit, or a taste for soda?
Apply the same argument to healthcare. The main difference is that you think that you have the right to tell people what's good for them.
> This hypothetical tax is meant to represent my desire not to have to deal with the consequences of your choices.
If a man and his son crack a couple beers by the fire in Wyoming, why should their private activities be any of your business? Why impose your will more on the poor than on the middle class or the rich? Your desires are not relevant to the right of ordinary Americans to buy and sell alcohol to and from the willing, just as they are irrelevant to the right of a single mother to raise her own son, or for teenagers to get pregnant; it's just none of your business what people do once you've said your piece, no matter what you think of the risk that they might tend to be more likely to behave in a way you dislike.
Then who should ?
You can blame everything on individuals: "they're lazy", "they're dumb", "they didn't work as hard as I did", "they could save themselves", that's very easy to do, and reassuring in a way. But that's also a very bleak view on our social organization.
Or you can admit that we're all infinitely small parts of a gigantic machinery, that we're all mutually responsible for the system we live in, and that some of the issues raised here are direct consequences of "the state" and its policies.
Just like some people are born in good conditions, probably a majority of hn readers are, a lot of people are not. You don't have to care, you don't have to help them, but at least don't criticize people trying to better society.
Even if you don't care about people and just think in numbers, getting these people out of misery/addiction is a net positive for society on purely a monetary perspective.
I think the lazy people are those who think they should attempt to fix social ills by levying regressive taxes, rather than doing the actual work of convincing and helping people to do better.
> Or you can admit that we're all infinitely small parts of a gigantic machinery, that we're all mutually responsible for the system we live in, and that some of the issues raised here are direct consequences of "the state" and its policies.
But you are not responsible for, nor entitled to, deciding what people do to themselves in private. When a lone free man hurts himself, no injustice is carried out in the act.
> Just like some people are born in good conditions, probably a majority of hn readers are, a lot of people are not. You don't have to care, you don't have to help them, but at least don't criticize people trying to better society.
You can try to better society all you want, but do it without worsening the part of society where people drink responsibly but live on a budget. Minimum pricing punishes all people who buy alcohol for the perceived benefit of those who are presumed to be prone to abusing it, that is why it is unjust. If you just want to better society, work with your local chapter of alcoholics anonymous. If you're just going to sign off on the minimum pricing laws and feel morally righteous about it (because you have no skin in the game), then surely you are the one who is failing morally; the compulsion to "do something, anything!" about each perceived societal ill does not make you a good person.
> Even if you don't care about people and just think in numbers, getting these people out of misery/addiction is a net positive for society on purely a monetary perspective.
I think the whole thing is an exercise in not caring about people and just thinking in numbers. It is not your right to go around imposing your vision of the moral duties one owes to oneself.
The moral wrong of imposing a regressive tax on your personal pet peeves is long lasting, and indicates a lack of commitment to principle. Society does not benefit, on the whole, from standing in favour of an endless stream of petty tyrannies.
Your compulsion to control other people's alcohol consumption by fiat is purely selfish, no matter what you tell yourself, and no matter what word games you choose to impugn the character of those who don't agree.
Minimum unit pricing is a good way to do this, especially if the money raised is hypothecated for alcohol treatment programmes.
What about forcible vaccination? Forcible quarantine? This issue hits close to home, but I still don't see how it is better to prohibit lawful access to alcohol to the poor than it is to support CPS in their overlapping duties.
> Minimum unit pricing is a good way to do this, especially if the money raised is hypothecated for alcohol treatment programmes.
Why do middle class alcoholics get to risk abusing their families more readily than poor alcoholics?
We have (33.5%, per capita [similar difference in median]) lower household disposable incomes in Canada, and very high minimum unit prices. In 2015, the rate of death due to conditions entirely caused by alcohol was around 8.6 per 100,000; about 150% the rate of death in motor vehicle accidents. It's hard to compare the stats between the two countries since the U.S. tends to track "alcohol-related deaths", whereas Canada tends to track "hospitalization due to conditions entirely caused by alcohol" and "death due to conditions entirely caused by alcohol". The National Hospital Discharge Survey indicated in 2010 that approximately 390,000 hospital discharge episodes for persons ages 15 and older had an alcohol-related principal diagnosis, so assuming the worst, one person per discharge, an annual rate of ~126 per 100,000 2010 census persons; in 2015 there were ~77,000 hospitalizations entirely caused by alcohol (a stricter subset, I think), assuming again one person per hospitalization, an annual rate of ~214 per 100,000 estimated Canadians.
I do not think it is settled that particularly high unit prices will reduce rates of death and hospitalization; and as far as I'm aware, we don't have the comparable numbers between the U.S. and Canada (let alone the U.S. and the world at large relative to minimum unit prices), let alone finer grained jurisdictional comparisons, to draw any conclusions like that.
And all of this notwithstanding, I think it is unamerican (as a dual citizen of Canada and the U.S.) to tell free adult people what personal risks they are not entitled to, especially in the form of a regressive price fixing scheme, and I think this is not a proper or appropriate solution to alcohol-related domestic violence.
What's wrong with trying to stop people dying?
(The regressive aspect I get, but you seem to be against non-regressive measures too.)
If only it were that easy.
Alcohol taxes are a valuable source of revenue for cities. The area I’m moving to is trying to incorporate. The alcohol taxes and restaurant permits will directly fund police, fire, and sanitation. It will allow us to improve services without relying on the county.
The problem is that American voters let the health industry get away with stuff like the fraudulent opiate prescription practices...
For profit isn't an issue per say, but when you add greedy executives in the mix you're in for a disaster. Look at insulin or other basic necessities, companies clearly put profit over people. I don't think that would fly in any other first world country.
Again, mostly the government should tell the industry to knock it off, mainly by empowering the demand side rather than the supply side.
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?
How many families have been torn apart by alcoholism? How many drunk driving deaths? And yet it still doesn't get the stigma of being "drugs" - this is the bullshit I'm referring to.
Every day is a gift, folks.
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.
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?
<<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.>>
I'm just not sure that all of this is down to material prosperity?
Blacks and hispanics have been much more poor, with far fewer prospects, for much longer, and yet this suicide and opioid overdose issue seems to affect whites disproportionately. That suggests maybe two things, either blacks and hispanics have been poor for so long that they are accustomed to it, or the suicide rate doesn't have as much to do with material prosperity as you seem to suggest.
It could have to do with material prosperity, I'm not saying you're definitely wrong. I'm just pointing out the fact that there is evidence, in black and hispanic poverty rates, that agitates against that explanation.
What about adrenaline-junkies that might be doing it due to despair.
I think your question is:
Everything being nominal in an average human's life, what's the age where natural systems cause death?
I think the answer is probably related to the number of cycles before the heart goes out. There some research that there is a set amount of beats per life.
>Studies have concluded that all mammals get about a billion heartbeats per lifetime.
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.)
Are there any programs in the US helping solve this enormous divide?
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.
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.
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.
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.
(accessed September 2017).
I have trouble taking this document seriously after that.
"... 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.
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?
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.
I'm just saying the outrage machine is unavoidable. I've had friends and family that are deeply effected by it even if they don't openly admit it. Friends that are in rehab for opioids. Friends and co-workers that do nothing but smoke pot so they don't have to worry about their lives. Family members that became fox news addicts and blatant racists. I'd even argue that you're effected by it. You have to actively avoid it right? You understand the outrage machine and have actively decided to disconnect yourself from that world. Not saying that you're doing the wrong thing, just saying the outrage machine effects everyone. People that aren't particularly smart, financially successful, strong or mentally stable get hit by it much worse.
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.
Alongside all of the tragedies you mentioned, an entire host of miracles have occurred as well. Technological advances in healthcare show no sign of slowing, market forces (and public pressure) are slowly but surely moving us toward a future powered by green energy, US-based companies are now sending missions to the ISS and mass-producing electric vehicles, and the USA still has the greatest institutions of higher learning in the world. On a minor technical note that may seem insignificant but is near and dear to my own heart: it's 2019 and there are now more flavors of *Nix (and users of the same) than ever before - free software is still going strong despite the tech behemoths' anti-choice tendencies. On the front page of HN right now is a story about the mass exodus of users from FaceBook (an indicator that the public is waking up to the damaging effects of emotionally-predatory social media).
In the political sphere, too, there are signs of significant improvement. The 2018 midterm elections revealed a public who is more informed about and interested in governmental oversight than at any point in the past decade at least, more attention than ever is being paid to white-collar corruption and chicanery, the best efforts of our unindicted co-conspirator in-chief (and his merry band of sycophants) haven't succeeded in quashing the myriad investigations into his (and his family's) business and political activities, and the most popular politician in the country (according to some recent polls) is an avowed anti-corruption advocate who supports universal healthcare, a resolution of wealth inequality, and an end to endless overseas warfare. On your drug points: every major contender for the Democratic presidential nominee (that I'm aware of) favors a rebalancing of federal drug enforcement priorities to bring sanity to the discussion (funding for research into the use of psychedelic drugs for therapy & the decriminalization of marijuana). On the gun front: there has never been more public support for (slightly) more sane gun restrictions than there are now.
There are many places we need to improve, but there is much to be grateful for, optimistic about, and proud of as well. The reason I say this is not in an attempt to refute or mitigate your points, but to emphasize the need to periodically remove oneself from the negative data streams and pay attention to the good evidence as well.
People living in garbage dumps are able to figure out to be happy.
And America was built on our own industry - the rest of the world had marginal input. Sure greed ran over our borders, but that was a sad side effect and not necessary for America's amazing growth.
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.
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.
Also that Japan, notorious for a suicide culture, is only 30th. Maybe if they counted all the murders made to look like suicide, they would be further up.
> The US is nowhere near the top in terms of suicide rates in the world.
... Is that really an argument against action?
> compared to heart disease, strokes, cancer or diabetes.
Because studies have shown that making a small effort will make a large difference in suicide rates... It would be great if we could cure cancer, but we just can't.
How about "2017 saw highest increase in death due to alcohol, drugs and suicide in US history"?