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Drug abuse is a main driver behind America’s rising rate of ‘deaths of despair’

A study by the Joint Economic Committee found deaths of despair (suicide, alcohol and drug abuse) have trended upward since the mid-1950s, with drug overdoses being the primary contributor.

This Tuesday, Aug. 15, 2017 file photo shows an arrangement of pills of the opioid oxycodone-acetaminophen in New York.
This Tuesday, Aug. 15, 2017 file photo shows an arrangement of pills of the opioid oxycodone-acetaminophen in New York.
Patrick Sison, Associated Press

SALT LAKE CITY — Drug abuse, particularly the ongoing opioid crisis, has been the primary driver behind an upward trend of so-called deaths of despair dating back to the mid-1950s but skyrocketing in the past 20 years, according to a new congressional report released Thursday.

An examination of long-term data by the Joint Economic Committee shows deaths by suicide and alcohol abuse gradually climbing from the 1950s to the 1970s, then leveling off with periods of decline until 2000. But data on drug-related deaths show a steady increase during the same time period. All three causes of death have increased since 2000, with drug abuse showing a noticeably steep ascent, researchers found.

The composite deaths-of-despair rate tracks a similar course, rising from the mid-1950s to the mid-1970s, then stabilizing but still trending upward before shooting up after 2000. “In 2000, there were 22.7 deaths of despair per 100,000 Americans — not that different from the 1970 rate of 21.5,” the committee report stated. “By 2017, the rate had doubled to 45.8 per 100,000

Deaths of despair
Deaths of despair

The National Center for Health Statistics found deaths of despair have caused life expectancy in the U.S. to decline for two consecutive years (2015 and 2016), offsetting declines in mortality from heart disease and cancer.

The committee examined the deaths-of-despair phenomenon to determine if it tied into its Social Capital Project. The project, spearheaded by committee chairman Sen. Mike Lee, R-Utah, is a multi-year initiative investigating how opportunities for economic mobility and growth are connected to the nature, quality and importance of Americans’ relationships with family, friends, neighbors, coworkers and others in a community.

But, the recent report found the connection between social capital components and deaths of despair elusive.

“Given the lack of correspondence between trends in economic and social indicators, unhappiness, loneliness, and deaths of ‘despair,’ it may be more productive for policymakers to focus on the overdose epidemic than on despair per se,” the report stated.

Deaths of despair are not unique to this century. The committee report shows a sharp increase at the turn of the 20th century until 1907, a level that wasn’t surpassed until 2013.

While the report doesn’t delve into historical context behind the fluctuations in the deaths from suicide, alcoholism and drug overdoses, it does mention some events that “might explain some of the changes over time.” Those events include the Pure Food and Drug Act (1906), the Panic of 1907 (1907-08), the Harrison Narcotics Tax Act (1914), World War I, the flu epidemic of 1918 (1918-19), the depression of 1920-21, Prohibition (1920-33), the Great Depression (1929-38), World War II (1939-45), and the counterculture revolution of the 1960s.

While the committee report attributes the recent increase in deaths of despair to an “unprecedented epidemic of drug overdoses,” it noted that “the combined mortality rate from suicides and alcohol-related deaths is higher than at any point in more than 100 years. Suicides have not been so common since 1938, and one has to go back to the 1910s to find mortality from alcohol-related deaths as high as today’s.”

The term despair suggests a correlation with reported levels of unhappiness. But researchers found self-reported unhappiness predates the increase in deaths of despair by a decade.

“Rising unhappiness may have increased the demand for ways to numb or end despair, such that the cumulative effects show up years later in the form of higher death rates,” the report stated. “But the proliferation of a uniquely addictive and deadly class of drugs has meant that the supply of despair relief has become more prevalent and more lethal, which would have increased mortality even absent an increase in despair.”

While the report is cautious in identifying causes and makes no policy recommendations, other research that first declared an epidemic of despair is killing Americans identified financial insecurity as one cause, the Deseret News reported in 2018.

“In a paper published in 2017, (Anne Case and Angus Deaton of Princeton University) argued that despair is cumulative. Young people with limited education who struggle to enter the workforce accumulate disadvantages over the course of several decades, not only economically, but in their health and family outcomes.”

The Deseret News story also explored the unique role faith communities can play in helping stem the number of deaths of despair by more openly addressing mental health among their congregations.

“Like it or not, it’s still a taboo; you put the AA people in the basement, you whisper if someone goes to a psychiatric unit. If they have a nose job or a heart attack, full disclosure is fine, but if it’s psychiatric, you have to whisper,” said the Rev. Bill Roth, minister of congregational care at Myers Park United Methodist Church in Charlotte, North Carolina. “So one of our goals is to reduce the stigma of mental health.”