Americans are becoming more self-destructive.
While it’s no surprise that some people drink themselves to death, get hooked on lethal drugs or end their own lives, the rate of such behavior is increasing dramatically, according to a new report from the Trust for America’s Health and the Well Being Trust, both policy and advocacy non-profits.
And while rates of drug abuse and suicide among whites have long outnumbered minorities, the gap is closing fast.
Death rates from alcohol, drugs or suicide grew by 11% overall between 2015 and 2016, with drug-related deaths among blacks jumping 39%, the report found.
“What we’re seeing with this data are trends that are almost nightmarish,” said Benjamin Miller, a study author and chief strategy officer with the Well Being Trust, which aims to advance mental, social and spiritual health. “Everybody should just stop what they’re doing and pay attention to what in the world is happening here.”
Miller said he does not see these numbers tapering off anytime soon. “These trends, if anything, are only going to increase,” he said. “What are we going to do about that?”
The study only looked at the numbers — not the causes behind these trends.
But a few triggers are obvious, experts said, namely: opioids, which have spread from a few doctors’ prescriptions to a national crisis, and the lack of social and economic supports.
“People do the type of self-destructive behavior and engage in it to the point of death and despair when their lives are hopeless,” said Dayna Bowen Matthew, a professor of law and public health sciences at the University of Virginia Law School.
She said the problem is not so much a racial crisis as a national one. “When the criminal justice system, the employment system, the economy, the housing system and people’s safety nets are broken, they are in despair,” Matthew said. “Whether you’re black, white or purple, people turn to self-medicating with drugs.”
Kelly Clark, president of the American Society of Addiction Medicine, which represents more than 5,000 addiction specialists, said the drugs themselves are a big part of the problem.
Based in Kentucky, she said she saw the opioid epidemic begin in rural Appalachia a decade ago, with mine workers being prescribed opioids so they could work through their pain.
“We see many people who became addicted with opioids or had problems who would not have addictive disease until they were prescribed these medications,” she said. “People took the medications in order to do the work they needed to do. But our brains were not built for these opioids.”
Opioid addiction was largely a white problem then, she said, because prescriptions were mostly handed out in white communities, first in rural and then suburban areas.
But as doctors became stricter with prescriptions, people with addictions turned to illegal distribution systems. And now, opioids — including extremely dangerous synthetic drugs like fentanyl – are reaching more urban areas and the traditional urban gang structures, which are less Caucasian, she said.
The report should be a call to action, said Andy Slavitt, former acting administrator of the Centers for Medicare and Medicaid Services in the Obama administration, who is now a senior adviser to the Bipartisan Policy Center, a non-profit Washington think-tank.
“Perhaps it’s one of these moments when for a variety of reasons people start paying attention to what’s going on,” he said.
With increased focus on mental health in the aftermath of the latest school shooting, the time is right to get Congress and the states to support expanding mental health care, Slavitt said. “This is a place we need to invest in.”
Clark also strongly supports more investment in mental health and addiction treatment — mainly one of three federally approved medications, plus counseling.
“There’s still a lack of education about what people expect out of treatment and what is quality treatment,” said Clark, also chief medical officer of CleanSlate Addiction Treatment Centers, which has cared for more than 8,000 patients in eight states.
Many experts still insist — contrary to evidence, she said — that people with addictions shouldn’t be taking medications. In addition, she said, families and patients need to view addiction as a chronic illness, not something that can be cured with one treatment.
Matthew said that self-destructive behaviors need to also be addressed by providing better public housing, employment opportunities, education and family-centered treatment.
“The drum I’d like to beat the loudest is that victims of drug crises in this country should all be treated with public health tools,” she said. People with addictions who were previously dealt with as criminals should instead be treated as patients.
“Finally we’re realizing this is a disease,” she said. “Everybody — past, present and future victims — should equally be treated with public health responses.”
Slavitt said there are clear, concrete steps that can be taken to de-stigmatize addiction and integrate care around the whole person.
“We will absolutely make progress,” he said. “We ought to begin right now.”
We need a “carrot and stick” for addicts; rewards for doing the right thing and adverse consequences for failure to recover…
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