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The number of annual deaths in the U.S. from alcohol, drugs and suicide has more than doubled in the past two decades, according to a report from The Well Being Trust published May 12.

There were roughly 156,000 deaths in 2019 due to alcohol, drugs and suicide, up from just over 60,000 in 1999.

Over this period, alcohol deaths rose from around 20,000 to just over 39,000, suicide deaths increased from around 30,000 to over 47,000, and drug deaths rose from around 20,000 to more than 74,000.

Since 2009, 18- to 34-year-olds have seen the sharpest rise in the alcohol-induced mortality rate, increasing by around 110%.

Suicide mortality rates have risen the most among 17-year-olds and younger (nearly 60%) while there has been a rate increase of around 35% among 18- to 34-year-olds over the past two decades.

In 2009, only two states – Alaska and New Mexico – had more than 50 deaths per 100,000 population related to alcohol, drugs and suicide, with 35 states (including D.C.) reporting fewer than 35 per 100,000.

By 2019, 27 states (including D.C.) had more than 50 per 100,000 people, with New Mexico and West Virginia having more than 75 per 100,000, and only New York and Texas reporting fewer than 35 per 100,000.

The nationwide rate was 45.7 deaths per 100,000 – a 52% increase from 2009.

These figures don’t account for the impact of the COVID-19 pandemic, but the initial data reveals that anxiety and depression have tripled among some age groups since 2019.

From April 2020 to March 2021, nearly 40% of all U.S. adults reported symptoms of anxiety or depression, with the highest levels (over 50%) among 18- to 29-year-olds.

A June 2020 survey by the CDC found the highest increase (25%) in substance use during the pandemic was among 18- to 24-year-olds, compared to 13% of all adults reporting that they “started or increased substance use to cope with pandemic-related stress or emotions.”

“The COVID-19 pandemic that enveloped the world in 2020 has created additional stressors to the already devastating situation, and emerging data indicates that Americans are struggling with much higher rates of distress, substance use and drug overdoses over the past year,” the report said.

“Without urgent action, mental health and substance issues – already on a grim trajectory – may continue to rise in the coming years and lead to more deaths from alcohol, drugs and suicide.”

The full report is available here. An executive summary is available here.

Editor’s note: May is Mental Health Awareness Month. A series of articles published during the week of May 17-21 that focused on mental health is available here.

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