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article imageStudy shows geographical trends in drug-related deaths in U.S.

By Karen Graham     Mar 18, 2018 in Health
Deaths from drug-use disorders in the U.S. have risen dramatically in the past several decades, hitting West Virginia and Kentucky especially hard, even as mortality rates blamed on other causes, from substance abuse or intentional injury have dropped.
To be specific, from 1980 to 2014, 2.84 million Americans died of alcohol, drugs, suicide, domestic violence or abuse, according to a study published Tuesday in the Journal of the American Medical Association (JAMA).
The most alarming data to come out of the study? - Drug deaths increased by more than 600 percent in this time period.
Looking at local trends in drug-related deaths
The study examining county-level mortality data on mortality due to alcohol use disorders, drug use disorders, self-harm (or suicide), and interpersonal violence or (domestic abuse).
Researchers found that over half a million people lost their lives to "drug use disorders" in this period, and while the rates of deaths varied widely, with increases between 8.2 percent and 8,369 percent, drug deaths were up in nearly every single county in the United States.
Many of the regions that saw the biggest jump in drug-related deaths are familiar from media stories covering the nation's opioid crisis. Boone County West Virginia saw the biggest rise in drug overdose deaths - 8369.7 percent, followed by Wyoming County, West Virginia which saw a rise of 6973.1 percent.
Counties in Kentucky, Ohio, Indiana and eastern Oklahoma saw the greatest increases in drug deaths: with more than a 5,000 percent increase.
"This study is the first to consider alcohol and drug use disorders, apart from other types of unintentional poisonings and distinct from intentional overdoses, at the county level in the United States," the researchers explained in the study.
Study co-author Ali Mokdad, a professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington explained: "It is important to show the local burden of these diseases so health officials and others can better plan programs and interventions in their own communities."
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Results of the study are surprising
A new small-area methodology was used to estimate county-level trends and mortality rates from 21 major disorders. Additionally, small-area estimation models were used to describe county-level trends in mortality rates separately for 4 causes: alcohol use disorders, drug use disorders, self-harm, and interpersonal violence from 1980 to 2014.
The study shows that deadly alcohol use disorders decreased by 8.1 percent over the length of the study period, driven by an 11 percent decline between 1980 and 2000 alone. Suicide rates overall decreased 6 percent, while deaths from domestic violence or abuse dropped 44.9 percent.
"This is a really important paper because it debunks a popular argument," said Dr. Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing, who was not involved in the study, reports CNN News.
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The argument that drug-related deaths are not unique and are "deaths of despair" rather than deaths of addiction is erroneous. If this were true, it means that opioids are not the cause of the soaring death rates, and it's the shrinking middle class and downward economic mobility that is killing people.
"If this was a 'deaths of despair' phenomenon, you would likely see alcohol deaths and suicides and all these factors rising together in the same areas," Kolodny said. "But this paper debunks that. There are geographic differences, and the rates of deaths didn't all go up together."
"This paper shows that opioids are really part of the overall problem," Kolodny said. "People are drugging themselves to death because this is an epidemic of addiction."
"In our previous work, we showed that many factors drive health outcomes such as access to and quality of healthcare, risk factors, and socioeconomic factors," Mokdad said.
"Understanding the drivers of drug use from education, income or mental factors is crucial to best develop and implement programs or policies to address the epidemic. Our data provides such an opportunity for our country to do so."
More about drugrelated deaths, countylevel rates, deaths of despair, health screening, JAMA
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