The combined number of U.S. deaths from alcohol, drugs and suicide jumped 20% from 2019 to 2020, according to a report published in late May by Trust for America’s Health.

Total deaths reached nearly 187,000 in 2020, with over 96,000 drug-related, over 49,000 alcohol-related and nearly 46,000 from suicide.

While the number of suicides declined slightly from 2019 to 2020, the overall percentage increase in deaths from all three causes was driven by a 27% increase in alcohol-induced deaths and a 30% rise in drug-induced deaths.

The drug-related death increase was driven by a sharp rise in synthetic opiod deaths, which rose from just over 11 per 100,000 in population in 2019 to nearly 18 per 100,000 in 2020. Other than the heroin mortality rate, which declined slightly in 2020, the rates for cocaine, for natural / semi-synthetic opioids and for other psychostimulants all increased, as well.

Drug-induced deaths have increased five-fold over the past two decades. There were 19,720 drug-induced deaths in 2000, rising to 33,541 in 20015, to 40,393 in 2010, to 55,403 in 2015 and to 96,096 in 2020.

The mortality rate from drug-related deaths was highest among Blacks (35.4 per 100,000 in population), followed by whites (30.9), American Indians (28.1), Latinos (18.4) and Asians (6.0).

“Over the past two and half decades, several developments in drug availability and supply combined with inadequacies in the healthcare system, and specific social, economic, and environmental conditions in the United States converged to start and grow the latest drug overdose crises,” the report said. “These conditions — including fragmented safety nets and health care systems, long-term rising economic inequality, and historic and ongoing racial/ethnic discrimination and inequities — have shaped the overdose response as well.”

Alcohol-induced deaths in 2020 were highest among American Indians (42.4 per 100,000 in population), followed by whites (14.1), Latinos (12.6), Blacks (9.3) and Asians (3.2).

The suicide rate declined 3% in 2020, the second straight year it dropped, with 45,979 people in the U.S. dying from suicide. However, the report offered several qualifications regarding the overall decline, noting that “the rate is still 30% higher than in 2000,” that “rates among young adults ages 18 to 34 increased” and that there were rate increases for American Indians / Alaska Natives, Blacks and Latinos.

Mortality rates for suicide were highest among whites (15.1 per 100,000 in population), followed by American Indians (14.6), Latinos (7.5), Blacks (7.4) and Asians (6.8).

A majority (53%) of suicides in 2020 were by firearm, while 27% were by suffocation / hanging, 12% by poisoning / overdose and 8% by other means.

One of several proposed solutions in the report is the Community Initiated Care model that provides evidence-based training programs for communities to help with early interventions.

“Through the task-sharing approach, health promotion, prevention, and low-intensity interventions can be delivered by a range of both lay members of the community and professionals, including but not limited to barbers and beauticians, teachers, faith-based and spiritual leaders, community health workers, peer support specialists, first-responders, safety net providers, and many others regularly engaged in community settings,” the report said.

The full report is available here.

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