U S. Alcohol-Related Deaths Rise, Especially Among Women, Study Says : NPR

They identified three distinct opioid epidemics (prescription opioids, heroin, and prescription–synthetic opioid mixtures) and one syndemic14 involving multiple opioids and other drugs. They found that counties with prescription-related epidemics had been “left behind” in the economic restructuring that occurred during the 1970s and 1980s. These communities were less populated and more remote, were older and mostly White, had a history of substance use, and were former farm and factory communities that had been in decline for several decades. By contrast, counties with high rates of heroin overdose and those classified as “syndemic” counties tended to be more urban, connected to interstates, more racially diverse, and in general more economically secure.

• At one time, these communities, often buoyed by thriving industries and busy plants or mines, were characterized by economic and family stability; unskilled and less-educated workers could find steady work with decent benefits, and social mobility was a possibility.
• Recent research has attempted to examine trends in psychological distress and despair-related behavior.
• In a subsequent study, Ho (2017) conducted a thorough analysis of changes in U.S. death rates due to drug poisoning between 1992 and 2011, stratified by educational attainment.
• Most of the 145 countries that reported data did not have a specific budget line or data on governmental expenditures for treatment of substance use disorders.
• A study published this week by the Centers for Disease Control and Prevention estimated an annual average of nearly 138,000 people dying from alcohol-related causes, such as motor vehicle crashes, alcohol poisoning, cancer and cirrhosis, based on data from 2016 to 2017.
• The report highlights the urgent need to accelerate actions globally towards achieving Sustainable Development Goal (SDG)  target 3.5 by 2030 by reducing alcohol and drug consumption and improving access to quality treatment for substance use disorders.

Global beer consumption

In the chart, we see the average consumption (in liters of ethanol) of different beverage types per person in the USA since the mid-nineteenth century. By default, the data for France is shown – in recent decades, here, the share of beer consumption increased to make up around a fifth of alcohol consumption in France. Drug use disorders are often classified within the same category as mental health disorders — research and data on mental health can be found on our topic page here.

Alcohol Consumption

Applying learning theory to addiction has robust clinical implications, such as the potential for teaching strategies for reducing addictive behaviors. Still, the psychological model does not account for the social and environmental context of a person’s experience with addiction. However, the FDA bases its https://ecosoberhouse.com/ approval decision on the data provided by the manufacturer at the time of the NDA [New Drug Application] and does not require that trials of investigational drugs be conducted with particular characteristics. Some of the greatest increases were found among women and people who were middle-aged and older.

Rethinking Drinking

Instead, he attributes most of the drug mortality increase to the “drug environment” (i.e., the cost, supply, and regulation of drugs). Scholars have debated whether the rise in drug poisonings is due to the increased availability of drugs (supply side) or the increased vulnerability of certain population groups (demand side). Scholars who support the former explanation point to the actions of legal and illegal drug suppliers and regulatory failures of government agencies, primarily the Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA) (Kolodny et al., 2015). These scholars chronicle the increases in the availability of inexpensive highly addictive and lethal drugs. Scholars who point to increases in the vulnerability of population groups reference the social determinants of health that put some individuals and communities at risk of addiction and substance misuse (Dasgupta, Beletsky, and Ciccarone, 2018).

The Role of Alcohol, Drugs, and Deaths of Despair in the U.S.’s Falling Life Expectancy

Among males, the other top-ranked states for increases were Maine, Ohio, Vermont, Kentucky, and New Hampshire. For females, the other top-ranked states for increases were New Jersey, Ohio, Kentucky, and Maine. Looking at death certificates from 2017 nearly 75,000 people died in the U.S. in 2017 from liver disease and alcohol-related conditions, a steep rise from 1999, when 36,000 died from those causes. Women used to die at lower rates from these conditions, but that gap has closed.11 As reported first by Case and Deaton and reiterated in their upcoming book,12 rising morbidity and mortality among whites due to accidents, drug overdoses, alcoholism, liver disease, and suicides means reduced overall longevity. These deaths are alarming businesses, too, as there are more suicides in the workplace than in the past.13 I expect that suicides, as well as overdose deaths, are undercounted.14 This should not be surprising as suicide is generally more stigmatized than accidental overdose.

Information from more complete and accurate death certificates could also be integrated into population surveillance, cohort studies, and interventional clinical trials addressing use of drugs and alcohol. Demand-related explanations for the surge in substance use and overdose over the past three decades focus on why certain subpopulations and geographic areas appear to be more vulnerable than others to increased exposure to opioids and other drugs. These explanations include those that are both proximate to individuals (physical pain, mental illness, ACEs, psychological distress or despair) and those that are more structural and distal (macro-level economic, family, and social changes). Muennig and colleagues (2018) make the case for a longer-term trend of worsening psychological health in the United States since the early 1980s that spanned demographic groups.

U.S. Alcohol-Related Deaths Have Doubled, Study Says

Motivation ties to self-efficacy, the belief in one’s ability to stop engaging in such behavior. People who experience addiction use cognitive and behavioral self-regulatory strategies to resist cravings. Like the medical model, the psychological model does not emphasize individual choice but highlights the influence of learned reinforcement on the development of such behaviors.

Drinking Alone as a Teen May Foreshadow Future Alcohol…

By 2000 in these same places, OxyContin prescribing rates were 5–6 times higher than the national average (Van Zee, 2009). It is no coincidence that these were the first areas of the United States to experience widespread increases in opioid misuse, diversion, and overdose and demand for SUD treatment. In 1996, Purdue introduced and began heavily marketing OxyContin—an extended-release oxycodone product. Although several other opioid products were already difference between drugs and alcohol on the market, OxyContin is widely viewed as the product that fueled the surge in U.S. opioid addiction. This disinformation campaign made many physicians comfortable in prescribing the drug heavily to a wide range of patients. Purdue argued that OxyContin’s new slow-release long-acting formulation not only was more effective than existing opioids but also reduced the product’s ability to give users a high, and therefore its addiction potential.