Drug epidemic may kill much more Americans than scientists think

As the drug epidemic began to unfold in the United States, deaths classified as drug-related for 15- to 64-year-olds hit 9% in 2016, up from about 4% seven years prior.

In a new study, researchers found that drug-associated mortality in this country is actually more than double that.

The research was conducted by a team from the University of Pennsylvania and Georgetown University.

The team says it’s obvious that the drug epidemic is a major American disaster. The basic records being kept are annual reports on the number of deaths from a drug overdose. But that’s only part of the picture.

Among this group of Americans in 2016, 63,000 deaths were attributed to drug-related causes—mostly poisonings—but the researchers estimate that the overall number of drug-associated deaths is far higher: around 142,000.

They also found that, on average, drug use decreased life expectancy after age 15 by 1.4 years for men and by 0.7 years for women—figures that more than doubled for the hardest-hit state, West Virginia.

To draw these conclusions, the researchers turned to a dataset from the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.

They built models to assess the mortality rates for males and females in all 50 states from 15 age groups and for 18 calendar years.

The dataset represented more than 44 million deaths, 667,196 of which were coded as related to drugs.

Their models eventually showed that drug-coded deaths, which include drug overdoses and mental and behavioral disorders related to drugs, represent only about half of all drug-associated deaths.

The team says infectious diseases like HIV/AIDS and hepatitis, impaired judgment, suicide, circulatory disease—these are all affected by drug use.

People who are perpetual drug users have much higher mortality in general.

The statistical associations between drug-coded deaths and other deaths suggest that drug use likely cost something in the neighborhood of 142,000 deaths in 2016, or 2.2 times the number of death certificates that coded “drugs” as the underlying cause of death.

The team then looked at life expectancy. They found that drug use shaved off nearly a year-and-a-half of life for men and three-quarters of a year for women.

West Virginia—known to be the opioid crisis epicenter, with high drug-overdose rates—fared the worst, with drug-associated deaths for 15- to 64-year-olds hitting 39% for males and 27% for females.

Other states with high rates included Massachusetts, Maryland, Pennsylvania, and Ohio.

Nebraska, on the other end of the spectrum, fared best for both sexes, with Iowa, Montana, North Dakota, and South Dakota rounding out the five states with the lowest numbers among men.

Though this work does recalculate the magnitude of the drug problem in the U.S., the researchers say it doesn’t get at root causes.

Currently, two theories prevail: The first has to do with drug supply, fueled initially by a wave of addiction to prescription drugs like oxycontin, then again with street drugs like heroin, and finally by opioids like fentanyl.

One author of the study is Penn demographer Samuel Preston.

The study is published in PLOS ONE.

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