The US drug epidemic has likely claimed the lives of twice as many Americans as currently estimated, new research suggests.
The Centers for Disease Control and Prevention (CDC) estimates that there were 63,000 drug overdose deaths in 2016.
But that estimate doesn’t include non-overdose deaths that have drugs at their root, like those from HIV, suicide and blood vessel damage.
With these included, researchers from the University of Pennsylvania and Georgetown University estimate that a staggering 142,000 people died because of drugs in 2016 – 2.2 times more than federal data document.
Overdoses, particularly from opioids, have garnered widespread public health, media and governmental attention.
Drawing comparisons to the AIDS epidemic, drug overdoses killed more than 702,000 people in the US between 1999 to 2017.
‘It’s obvious that the drug epidemic is a major American disaster,’ says University of Pennsylvania professor and study co-author Samuel Preston.
‘The basic records being kept are annual reports on the number of deaths from drug overdose. But that’s only part of the picture.’
Those numbers are based off a coding system used on death certificates, which don’t account for causes of death that may have more complicated pathologies.
For example, if someone has taken drugs and gets into a car accident, those codes will not distinguish between a drug-involved vehicle death or any car accident death.
By more closely studying death data, the researchers unearthed proof that drugs have led to tens if not hundreds of thousands more deaths than previously thought.
‘Drugs can kill in other ways,’ says Preston.
‘Infectious disease like HIV/AIDS and hepatitis, impaired judgement, suicide, circulatory disease – these are all affected by drug use.
‘People who are perpetual drug users have much higher mortality in general.’
Over 20,000 men and 9,600 women died of circulatory diseases, such as heart failure, linked to their drug use.
Just under 1,00 women and nearly 3,000 men who used drugs died of infectious or parasitic diseases, including HIV and hepatitis.
Drugs likely led to deaths of ‘mental health/behavioral’ causes, like suicide, as well, although the number remains unclear.
Suicides are included alongside drug and alcohol overdoses as ‘deaths of despair,’ a category of fatalities that particularly burdens rural areas of middle America.
‘The rates [of newly-recognized drug-related deaths]are high in the Southwest, in Appalachia, and in New England,’ Preston said.
‘They’re low in the Great Plains. The fact that this imprint is so distinctive helped us identify statistically significant associations’
Although the researchers don’t know exactly why drug related deaths are so high in some areas, they suspect that despair itself may be a driver.
‘It’s not just about the supply of drugs but that there’s something else behind all of it that causes people to either use drugs or alcohol or commit suicide because they’ve lost interest in their life,’ said study senior author and Georgetown professor, Dana Glei.
Previous research has already blamed the opioid epidemic for driving the US life expectancy down for the last three years running.
The new study suggests that drugs have shortened even more of the typical American’s time on Earth than suspected.
After age 15, men can expect to live 1.4 fewer years in the US, in light of the new study.
Women loose about 0.7 years nationwide, and twice as much of their lives in hard-hit states like West Virginia.
‘The drug epidemic is probably killing a lot more Americans than we think,’ says Glei.
‘That’s the main point we’re trying to make.’