Drug overdose deaths are on the rise, but not only because of people’s declining economic fortunes.
New findings challenge previous conclusions about so-called “deaths of despair” among poorly educated white men in the U.S., which drew a connection between drug-related deaths and deteriorating economic conditions.
But the link between a a county’s economic deterioration and more deaths by drugs is weak. In fact, economic factors only accounted for less than one-tenth of the rise in drug and opioid-related deaths, according to “Deaths of despair or drug problems?,” a paper by University of Virginia researcher Christopher Ruhm, recently circulated by the Cambridge, Mass-based National Bureau of Economic Research. The study looked at county-level data on drug mortality rates between 1999 and 2015.
Rather than economic conditions, Ruhm found that “changes in the drug environment” were a bigger factor fueling drug deaths and, critically, the availability of substance abuse treatment centers that deal with these specific addictions.
‘Deaths of despair’ are on the rise
The mortality rate for white Americans with no more than a high school diploma was about 30% lower than the rate of black Americans in 1999, but in 2015, it was 30% higher, according to a 2017 paper by Washington, D.C.-based nonprofit public policy organization The Brookings Institution. There was no particular state hit hardest by the mortality rate, and both men and women were equally affected. The authors said these deaths were caused by a “deterioration in economic and social well-being” as well as drugs, alcohol and suicide.
Experts have said that many blue-collar, white, middle-aged men have been losing the battle against substance abuse. There were more than 63,600 drug overdose deaths in the United States in 2016, according to the Centers for Disease Control, and the age-adjusted rate of deaths involving synthetic opioids other than methadone (drugs such as fentanyl, fentanyl analogs, and tramadol), doubled between 2015 and 2016.
Also see: How much the opioid epidemic costs the U.S
“These results suggest that the ‘deaths of despair’ framing, while provocative, is unlikely to explain the main sources of the fatal drug epidemic,” Ruhm wrote in his most recent paper, “and that efforts to improve economic conditions in distressed locations, while desirable for other reasons, are not likely to yield significant reductions in drug mortality.” Instead, authorities should focus on preventative care to address drug problems and better treatment when they arise, he concluded.
The U.S. needs more treatment centers for opioids
But the most recent study suggests that economic problems don’t tell the whole story. The dearth of appropriate treatment centers may also play a major part. Case in point: Methadone, buprenorphine, and naltrexone are the three drugs used to combat the effects of opioid addiction, and treatment centers need at least three specific treatments to deal with opioid addicts, according to the journal HealthAffairs.org.
For example, “Naltrexone requires patients to undergo a minimum 7- to 10-day detoxification before initiation, which may not be right for patients who need to begin treatment immediately,” Health Affairs wrote. “Similarly, some patients are averse to taking opioid agonist drugs as part of treatment and may therefore prefer the use of naltrexone, an opioid antagonist.” But only 2.7% or 319 of 12,029 substance abuse medical facilities provided all three forms of medication-assisted treatment, Health Affairs found.