Drug Overdoses Contributed to the Latest Drop in American Life Expectancy

The population’s life expectancy is arguably the most reliable metric that health experts and policymakers have for determining the overall health of a society. With that in mind, the CDC just released their provisional data for 2021 life expectancy. Sadly, American life expectancy dropped for the second year in a row, the first time a two-year drop has occurred in a century.

The Latest CDC Report Acts as a Stark Warning for Americans

In August 2022, the Centers for Disease Control and Prevention released their provisional life expectancy estimates for 2021. Key data points from that report are as follows:

• In 2020, life expectancy dropped two full years, from 79.0 in 2019 to 77.0 in 2020.
• In 2021, life expectancy dropped again, this time 0.9 years, declining to 76.1 years from 77.0 in 2020.
• After just two years of rising death rates, Americans are now expected to live three years less than they were in 2019.
• CDC experts equate much of the drop to Covid-19 deaths and unintentional injury deaths (car accidents, alcohol poisoning, and drug overdoses).
• According to the data, the most notable increase in unintentional injury deaths in 2021 was driven by drug overdoses.
• Despite the known increase, CDC experts believe deaths involving drug overdoses were almost certainly underestimated, which likely played an even more significant role in declining life expectancy than currently reported.
• There are also stark disparities in who is being affected by drug overdoses. During the pandemic, fatal drug overdoses skyrocketed 44% among Black Americans and 39% among American Indians and Alaskan Natives.
• Fatal overdoses also increased among White Americans during the pandemic, soaring 22% in 2020.

While the CDC data stands on its own merit, theirs is not the only data that points to soaring overdose deaths as a major factor in declining life expectancy. For example, in 2020, the Journal of the Missouri State Medical Association published a paper outlining how drug overdoses affected life expectancy even before the pandemic began.

That paper’s authors called drug-related deaths “Deaths of Despair” because they often occur among middle-aged Americans struggling financially in the wake of the 2008 housing crisis and as a result of a lack of gainful employment (or as a result of low-paying employment in dangerous work settings and high-injury-risk manual labor jobs). One author commented that if American policymakers and health professionals don’t work to halt deaths of despair, it will take the United States until 2116 to reach life expectancy levels that other high-income nations reached in 2016. Such an outcome would put the U.S. alone in the developed world for poor life expectancy results.

Another study published in the Journal of the American Medical Association outlines American life expectancy from 1959 to 2017. That study pointed out how, while Americans’ life expectancy increased overall (from 69.9 years in 1959 to 78.9 years in 2014), life expectancy declined somewhat between 2010 and 2017. The decline was primarily because middle-aged Americans died long before their time due to drug overdoses, alcohol-related poisonings, and other health complications.

Finally, it’s not just that Americans are using drugs more; it’s also that the drugs they’re using are more likely to cause deaths. In a perfect storm of misfortune, a drop in quality of life, a reduction in secure employment, and a general sense of lost security have been coupled with an increase in drug abuse as a coping mechanism and an increase in the use of highly potent, potentially lethal drugs. For example, many health experts believe the dramatic rise in overdose deaths is partially the result of highly potent drugs like fentanyl being spread into the drug supply.

Simply, not only are Americans more likely to use drugs as a coping mechanism today, the drugs they use are more likely to kill them than drugs used in previous generations.

Improving Life Expectancy Begins with Addressing the Root Causes of Premature Death

The data outlining the problem couldn’t be clearer, but the question remains: How do Americans reverse their declining life expectancy?

First and foremost, public health officials must make treatment methods accessible, primarily treatments that intervene between Americans and the causes of death that have become so widespread. That means Americans need more access to residential addiction treatment for drug addiction, alcohol rehab for alcoholism, and counseling and practical tools/life skills.

“… After the productivity slowdown in the early 1970s, and with widening income inequality, many of the baby-boom generation are the first to find, in midlife, that they will not be better off than were their parents…”

Beyond that, there’s been a fair amount of data suggesting job outsourcing, deindustrialization, increasing financialization of the economy, repeated recessions, and a hollowing out of the working class have also contributed to deaths of despair. The authors of one study put it this way, comparing the U.S. employment system and pension safety net for retirees to that of other developed countries, “Although the epidemic of pain, suicide, and drug overdoses preceded the financial crisis, ties to economic insecurity are possible. After the productivity slowdown in the early 1970s, and with widening income inequality, many of the baby-boom generation are the first to find, in midlife, that they will not be better off than were their parents. Growth in real median earnings has been slow for this group, especially those with only a high school education. However, the productivity slowdown is common to many rich countries, some of which have seen even slower growth in median earnings than the United States, yet none have had the same mortality experience. The United States has moved primarily to defined-contribution pension plans with associated stock market risk, whereas, in Europe, defined-benefit pensions are still the norm. Future financial insecurity may weigh more heavily on U.S. workers, if they perceive stock market risk harder to manage than earnings risk, or if they have contributed inadequately to defined-contribution plans.”

Those authors suggest that soaring drug and alcohol addiction, rising overdoses, and falling life expectancies could all be a part of a much larger problem, i.e., one that is connected to the broader U.S. economic and social system. A lack of a good-paying job, little sense of security, and reduced quality of life may all be the preconditions to drug addiction as a coping mechanism and fatal overdoses to follow.

The Need for Effective and Available Treatment

The U.S. has a long road ahead to improve its economic system, bring back jobs from overseas, and rebuild its middle class. These all must be accomplished to reverse the life expectancy decline. In the meantime, those who are already hooked on drugs need help immediately. Drug addiction is a life-or-death crisis that does not wait for social or economic change. If you know someone hooked on mind-altering substances, please ensure they get help at a qualified residential drug and alcohol rehab center as soon as possible.

Sources:

• CDC. “Provisional Life Expectancy Estimates for 2021.” Centers for Disease Control and Prevention, 2022. cdc.gov

• CDC. “Vital Signs: Drug Overdose Deaths, by Selected Sociodemographic and Social Determinants of Health Characteristics — 25 States and the District of Columbia, 2019–2020.” Centers for Disease Control and Prevention, 2022. cdc.gov

• NIH. “The Role of Alcohol, Drugs, and Deaths of Despair in the U.S.’s Falling Life Expectancy.” National Institute of Health, 2020. ncbi.nlm.nih.gov

• JAMA. “Life Expectancy and Mortality Rates in the United States, 1959-2017.” Journal of the American Medical Association, 2019. jamanetwork.com

• PNAS. “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century.” Proceedings of the Academy of Sciences, 2015. pnas.org

• NPR. “Overdose deaths continued to rise in 2021, reaching historic highs.” National Public Radio, 2022. npr.org