Drug overdose deaths have reached unprecedented levels in the United States. Over the past two decades, drug overdoses have more than tripled to become the leading cause of injury deaths in the US. They now outnumber deaths from motor vehicle accidents and homicides, according to data from the Centers for Disease Control and Prevention (CDC) / National Center for Health Statistics (NCHS) Compressed Mortality File and Cause of Death Files. Sadly, the epidemic shows no signs of leveling off: drug overdose mortality continued to rise through 2017, amounting to over 70,000 deaths in that year and increasing by 16 percent per year between 2014 and 2017 (Hedegaard, Warner, and Miniño 2018).
Are other high-income countries experiencing similar increases in drug overdose deaths, and are they likely to going forward? Dr. Jessica Ho, of the University of Southern California, has examined drug overdose death rates between 1994 and 2015 in 18 countries. The study published in Population and Development Review provides some insight.
US Drug Overdose Deaths Are 27 Times Higher Than Some Countries
Dr. Ho says the incidence United States’ drug overdose deaths have been dramatically pulling away from other high-income countries.
Alarmingly drug overdose mortality is now 3.5 times higher on average in the United States than other high-income countries. It’s 27 times higher than in Italy and Japan, which have the lowest drug overdose death rates. Between 2003 and 2013, drug overdose mortality increased by 0.73 (men) and 0.26 (women) deaths per 100,000 on average in the comparison countries compared with increases of 5.53 (men) and 4.15 (women) deaths per 100,000 in the United States.
She confirms that despite the experience of the US, the potential remains for drug overdose mortality to increase in other countries in the near future, as similar and troubling signs are already discernible in some countries.
“One of the most surprising findings from this study is that while Americans now have the highest drug overdose death rates, this hasn’t always been the case. In the late 1990s, Nordic countries like Finland and Sweden had the highest death rates.”
Other Countries At Risk Of Drug Overdose Deaths
“The countries that now look like they’re at greatest risk of following in the footsteps of the the U.S. are other Anglophone countries like Canada, Australia, and the United Kingdom,” said Dr. Ho. “Over time, we’ve seen huge shifts in drug overdose, and we need to pay attention to the factors that contribute to the development and continued persistence of this epidemic in the United States and, potentially, whether it spreads to other countries.”
Why Is This Current US Epidemic So Alarming?
While the US has experienced prior drug epidemics, the current epidemic is distinctive in three key aspects. According to Ho, “First, the magnitude of the contemporary epidemic in terms of the estimated number of users and deaths involved far exceeds that of prior epidemics. Second, the earlier epidemics were driven primarily by illicit substances (heroin in the 1970s and cocaine in the 1980s to early 1990s), while legal drugs (prescription opioids) played the main role in initiating and sustaining the contemporary epidemic until the most recent decade. Third, drug overdose mortality was previously concentrated in major cities like New York, Philadelphia, Baltimore, and San Francisco, while the contemporary epidemic has encompassed dramatic increases in drug overdose mortality in non-traditional locations, particularly midsize cities, suburbs, and rural areas (Paulozzi and Xi 2008; Rigg, Monnat, and Chavez 2018). This has led to a convergence in drug overdose mortality so that drug overdose death rates do not differ substantially between rural areas and metros at the national level, although a large amount of geographic heterogeneity exists in these patterns (Rigg, Monnat, and Chavez 2018).”