After record ‘deaths of despair’ in 2019, early pandemic data is grim


FILE – In this May 6, 2019 photo file photo an injection drug user, deposits used needles into a container at the IDEA exchange, in Miami. National data is incomplete, but available information suggests U.S. drug overdose deaths are on track to reach an all-time high. Addiction experts blame the pandemic, which has left people stressed and isolated, disrupted treatment and recovery programs, and contributed to an increasingly dangerous illicit drug supply. (AP Photo/Lynne Sladky, Fie)

(NEXSTAR) – New data show the heavy mental and emotional toll that the pandemic took on Americans in 2020, one year after the country saw record highs in alcohol- and drug-related deaths.

In 2019, more than 156,242 people died from so-called “deaths of despair,” according to a report out Tuesday from Trust for America’s Health, a health policy, research and advocacy non-profit, and Well Being Trust, a national foundation for the advancement of mental, social and spiritual health.

The report shows that such deaths – from suicide, alcohol and drugs – rose nearly every year, starting in 1999, until the beginning of the pandemic.

“We do know that 2019 told a pretty terrifying story,” Dr. Ben Miller, chief strategy officer of Well Being Trust, told Nexstar. Miller added that, based on early statistics, 2020 already appears to be worse.

Helplines saw a spike in activity during 2020, the report cited, with 891 percent more calls coming into the Disaster Distress Helpline at the Substance Abuse and Mental Health Services Administration in March than in the same month in 2019. On a bright note, preliminary data shows that the number of suicides actually decreased in 2020 despite the massive uptick in distress calls, but those numbers aren’t yet finalized.

The Centers for Disease Control and Prevention National Health Interview Survey found that 11 percent of adults above the age of 18 reported symptoms of anxiety or depressive disorders in 2019 – that number tripled by April of 2020.

Surveys found that alcohol and drug use rose sharply during 2020 as well. Of the Americans who responded to a June 2020 survey saying they had “started or increased substance use to cope with pandemic-related stress or emotions,” people between the ages of 18 and 24 (25%), unpaid adult caregivers (33%), essential workers (25%), individuals with existing anxiety disorders (27%), individuals with existing depressive disorders (25%) and individuals with existing PTSD (44%) reported the largest increases.

Not all communities affected equally

The pandemic’s disproportionate impact among racial and ethnic minorities went beyond hospitalizations and deaths from the virus, the report found. Black and Latino households were also more likely to report higher food insecurity, symptoms of anxiety or depression and job loss.

When the pandemic started to tear through American society, American Indian/Alaska Natives, Blacks and Latinos were at higher risk for several reasons, according to researchers. They were more likely to be exposed through essential and frontline jobs or while living in multigenerational homes.

Their cases of COVID were often worse, according to the report, because of preexisting conditions, lack of healthcare access and systemic inequities.

The report calls for the promotion of diversity and culturally appropriate care in the healthcare system, as well as expanding the mental health and substance use treatment workforce.

Young people disproportionately affected

In the last year, people between the ages of 18 and 29 were at least twice as likely to report symptoms of anxiety or depression as people above the age of 70, according to the CDC’s Household Pulse Survey.

“There has also been a significant increase in alcohol consumption and hospitalizations for alcohol related liver disease, particularly in the unusual demographic of women in their 20s and 30s,” Dr. Kelly J. Clark, found and president of Addiction Crisis Solutions, said in the report. “People identify boredom, increase availability, and increased stress as reasons for their increased alcohol use during COVID.”

Clark added that amid the uptick in substance abuse, the pandemic was forcing the closure of health care resources such as psychiatric and addiction treatment clinics.

2019 alcohol and drug deaths hit record highs

While the 2020 data is preliminary and still emerging, the numbers from 2019 showed increases in alcohol- and drug-related deaths, as well as massive jumps in deaths from specific drugs and among certain communities.

After many years, Blacks surpassed whites in age-adjusted, drug-induced deaths and now have a higher rate than any other race or ethnicity. There was a small increase for whites, but for all other races and ethnicities the death rate grew by four to six times.

The report found that overdoses from natural and semi-synthetic opioids and heroin dropped substantially while synthetic opioids, cocaine and other psychostimulants saw large increases.

American Indians had the highest alcohol-induced death rate, with increases in every group from 2018 to 2019 except among Americans age 0 to 17, whose rate remained the same.

“If we’re serious about getting this right, we’re going to have to provide different solutions for different communities,” Miller said.

Drug-induced deaths, which also include deaths combined with alcohol and suicide and not strictly overdoses, jumped 5 percent from 2018 to 74,511 in 2019.

Suicide was the only metric to decrease in 2019, but Dr. Miller warned that the data point might not be indicative of a trend after the full statistics from 2020 are compiled.

Reversing the rise in “deaths of despair”

Miller said he hopes a continued conversation around mortality trends in the U.S. will lead to a real conversation and change when it comes to health care and mental health in America.

Even if the pandemic were to somehow end in 2021, Miller said the trends coming out of the last decade, as well as the emerging data from 2020, aren’t likely to reverse on their own.

“If there are not services there for those who are already having an ongoing problem I don’t think those problems are going to get better,” Miller said.

The TFAH and WBT are calling for federal and state governments to step forward to take immediate action in three areas: Investing in prevention and conditions that promote health, addressing the worsening drug use and overdose crisis and transforming the mental health and substance use prevention system.

“I want to remind folks that pay attention to this report that these people are family members, colleagues,” Miller said. “If we just see them as numbers we’re not going to get to the place that we need to be.”

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