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U.S. death rate reaches all-time record due to alcohol, drugs and suicide

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The rate of U.S. deaths due to alcohol, drugs and suicide reached an all-time record in 2021, an increase of 11 percent, according to a new report released by Trust for America’s Health.

Pain in the Nation 2023: The Epidemics of Alcohol, Drug, and Suicide Deaths showed increases occurred among all ages, races and geographic groups and were alarmingly high for youth suicides and overdoses among certain populations of color.

In total, 209,225 Americans lost their lives due to alcohol, drugs or suicide. These deaths are part of a two-decade trend of sharply increasing fatalities due to substance misuse and suicide in the U.S.

The 2021 data showed such deaths were up across the U.S. population, with the largest increases occurring among certain populations of color as well as people living in the South, West and rural regions of the country.

“The data continue to show alarming increases in deaths due to substance misuse and suicide,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “What is needed is urgent and sustained investment in policies and programs that prevent the root causes of substance misuse and suicidality. We need to prevent adverse childhood experiences and trauma and support mental health services in schools, within healthcare settings and in community settings for all populations.”

The report also shows a new and growing threat from xylazine, a tranquilizer approved for veterinary use, but mixed with fentanyl, creates a highly toxic drug combination.

The full report is available online.

Drug overdose deaths

  • Increased by 14 percent between 2020 and 2021
  • Larger increases among Native Hawaiians and Pacific Islanders, American Indian/Alaska Native people, and among youth and older adults
  • Drug overdose rates were highest among adults ages 35 to 54, males, Black people, and young adults ages 18 to 34

Alcohol-induced deaths

  • Increased by 10 percent between 2020 and 2021
  • Highest increases among Native Hawaiians and Pacific Islanders, Latino people, and American Indian/Alaska Native people
  • Suicide death increased by 4 percent between 2020 and 2021, with the highest increases among American Indian/Alaska Native people and Black people

Two decades overview

  • Deaths due to alcohol, drugs and suicide have been on the rise for over two decades, doubling over the period from 104,379 deaths in 2011 to 209,225 in 2021
  • Between 2016 and 2021, the escalation in the rate of drug overdose deaths was more than 60 percent. These increases disproportionately impacted Black and Latino populations
  • Most of the upturn in deaths due to drug overdose involved opioid overdose, with additional deaths due to cocaine and psychostimulants
  • A new and growing threat is xylazine, a tranquilizer approved for veterinary use but mixed with fentanyl to create a highly toxic illicit drug combination
  • During the last two decades alcohol and suicide deaths have also increased, but not as sharply as drug deaths

Youth suicide risk

  • Over the last decade, alcohol, drug and suicide deaths among youth ages 10 to 17 increased by 65 percent
  • While youth have a much lower suicide rate than the general population, the upward trend of youth suicide, beginning well before the COVID-19 pandemic – a 71 percent increase tween 2010 and 2021 – is tragic and warrants immediate attention, according to Trust for America’s Health
  • Unlike for other age groups, an increase in suicide deaths among young people was the primary driver for the age group’s increased overall mortality
  • American Indian/Alaska Native and LGBTQ youth are most at risk for poor mental health and suicidal behaviors

Veteran suicide risk

  • Veteran suicide risk needs immediate attention
  • The suicide mortality rate for veterans was 32 deaths per 100,000 veterans in 2020, a much higher rate than the general population

Crystal Graham

Crystal Graham

Crystal Abbe Graham is the regional editor of Augusta Free Press. A 1999 graduate of Virginia Tech, she has worked for nearly 25 years as a reporter and editor for several Virginia publications, written a book, and garnered more than a dozen Virginia Press Association awards for writing and graphic design. She was the co-host of "Viewpoints," a weekly TV news show, and co-host of Virginia Tonight, a nightly TV news show. Her work on "Virginia Tonight" earned her a national Telly award for excellence in television.