Category: Drugs

Americans are killing themselves at an alarming rate. Nationwide, the mortality rate1, from drug poisoning, alcohol poisoning, and suicide increased by 52 percent between 2000 and 2014. Most of this increase was driven by a surge in prescription opioid and heroin overdoses, but overdoses from other drugs, suicides by means other than drugs, and alcohol-induced deaths also increased over this period. Between 2010 and 2014, drugs, alcohol, or suicide were the underlying cause of death for 537,000 people and were contributing factors in an additional 133,000 deaths.2 Especially striking is that mortality from drugs, alcohol, and suicide has increased during a period of declining mortality for other major causes of death, including diabetes, heart disease, most cancers, and motor vehicle accidents.3 Not all demographic groups are at equal risk of drug, alcohol, and suicide mortality. The highest rates are among young and middle-aged non-Hispanic white males,4 especially those in nonmetropolitan areas. All three types of mortality increased among white males and females from 2000 to 2014, but drug-induced causes produced the largest mortality increases (Figure 1). White males have the highest combined mortality rate for the three causes, but the combined rate for white females increased the most (by 123 percent). Hispanic females also experienced increases in all three causes of death, but their rates remained far lower than those for both white males and females. Drug and alcohol mortality actually declined among Hispanic males, though Hispanic males continue to have higher alcohol-induced mortality rates than white males. Hispanics are more likely than whites to abstain from drinking alcohol, but Hispanics who do drink consume alcohol in larger quantities and drink more often than whites.5 Although black male drug and alcohol mortality rates exceeded those of white males in the early 2000s, by the end of the decade the rates for black males had declined and were lower than those for white males. Rates for black females are low and relatively stable.

U.S. media and popular culture historically portrayed drug abuse as an urban problem, but in recent years, there has been more media attention on rural drug issues. Part of this growing attention pertains to the growing epidemic of narcotic painkiller abuse in rural America. Although all areas of the country experienced increases in painkiller prescribing, abuse, and mortality over the past two decades, the increases have been most pronounced in small towns and rural areas.1 This rural drug epidemic requires immediate attention from policy makers and practitioners.