Opioids, Alcohol, Suicide [...]

In contrast to every other major demographic, death rates for middle aged whites are rising, and rising fast. While part of this is attributable to increasing suicide rates, stunning new research indicates much of the increase is due to drug and alcohol abuse. The effect is centered in the poorest populations, and seems to be related to increased use of various legal and illegal drugs to curb pain. (nyt)


Analyzing health and mortality data from the Centers for Disease Control and Prevention and from other sources, they concluded that rising annual death rates among this group are being driven not by the big killers like heart disease and diabetes but by an epidemic of suicides and afflictions stemming from substance abuse: alcoholic liver disease and overdoses of heroin and prescription opioids. (nyt)

The researchers note that the magnitude of the increase is almost unprecedented: “the mortality rate for whites 45 to 54 years old with no more than a high school education increased by 134 deaths per 100,000 people from 1999 to 2014.”

The only precedent for this rapid a rise in death rates in a demographic? AIDS.

While the ramifications of the finding are enormous, the finding was discovered primarily by accident, during research into increases in the suicide rate.

Despite middle-aged mortality in the U.S. being one of the most studied demographic phenomena in recent history, the pattern had been largely missed. While many had looked at the data, no one had happened on the right slice to show the pattern:

Dr. Preston of the University of Pennsylvania noted that the National Academy of Sciences had published two monographs reporting that the United States had fallen behind other rich countries in improvements in life expectancy. One was on mortality below age 50 and the other on mortality above age 50. He coedited one of those reports. But, he said, because of the age divisions, the researchers analyzing the data missed what Dr. Deaton and Dr. Case found hiding in plain sight. (nyt)

Kevin Drum notes that why the headline is about middle-aged whites, the truth is that the trends are evident in all age groups:

But the paper is being misreported. It’s not just middle-aged whites. It’s all whites. The chart below tells the real story:every age group from 30 to 65 has shown a steep increase in mortality. So why focus just on middle-aged whites? “The midlife group is different only in that the sum of these deaths is large enough that the common growth rate changes the direction of all-cause mortality.” In other words, the midlife group makes for a more dramatic chart. But every age group has shown a similar trend.

To support this he shows his own chart of increases in white mortality at different age groups from the Opioids, Alcohol, and Suicide trend:

Mortality of Americans by age group (source)
Mortality of Americans by age group (source)

In fifteen years death by overdose, suicide, and liver conditions associated with drug and alcohol abuse have doubled in the white American population. So much so that they have changed the shape of all-cause mortality in middle age, but they are impacting other age brackets in profound ways as well.

The suicide trend among middle-aged white men is well known. See Suicide Belt, and Rising Suicides

“More than half of Americans now report a personal connection to painkiller abuse, 16 percent know someone who has died from an overdose, and 9 percent have seen a family member or close friend die.” [(Link)](http://www.motherjones.com/politics/2015/11/most-americans-now-have-personal-experience-painkiller-addiction quote)

By 2002, the trend was already terrifying and visible. See Opioid Increase 1997-2002

Standards bodies were involved with the increase. See JCAHO and the Opioid Epidemic