Alcohol dependency, substance abuse and suicides have soared in the US over the past decade, research suggests.
After looking at the insurance claim data of 12 million people, a team from the non-profit medical company Highmark Health in Pittsburgh found one in 20 (around 5%) were diagnosed with at least one “disease of despair” between 2007 and 2018.
Suicidal thoughts and behaviours specifically skyrocketed by 287% between 2009 and 2018 among people under 18.
Diseases of despair are said to have coincided with decades of economic decline, “loss of social safety nets”, and stagnant or falling wages, which may have triggered “disillusionment, precariousness and resignation”.
These conditions may then lead to “emotional, cognitive, behavioural and even biological changes” that allow a disease to progress, culminating in “deaths of despair”, the team warned.
The team analysed information on 12 million people who were enrolled in a Highmark Health insurance plan between 2007 and 2018.
Diseases of despair were defined as diagnoses related to alcohol dependency, substance abuse and suicidal thoughts or behaviours.
Overall, one in 20 of those on the insurance plan were diagnosed with at least one disease of despair during the study period. Of these, more than half (58.5%) were male, with an average age of 36.
Of the disease of despair patients, more than half (54%) were diagnosed with an alcohol-related disorder, while just over two in five (44%) had a substance-related condition and 16% endured suicidal thoughts or behaviours.
Just under 13% of the participants were diagnosed with more than one disease of despair, the results – published in the BMJ Open – reveal.
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Between 2009 and 2018, the overall rate of disease of despair diagnoses increased by 68%.
During these nine years, the rate of suicide-related diagnoses rose by 170%.
This was most pronounced in those under 18, however, the rate of suicidal thoughts and behaviours increased by 210% in people aged 18 to 34.
Substance and alcohol-related diagnoses, for all ages, went up 94% and 37%, respectively. The largest increase in these conditions occurred among people aged 55 to 74 at 59% and 172%, respectively.
Among babies, diseases like neonatal abstinence syndrome – when infants are exposed to drugs in the womb and then go through withdrawal – rose by 114%.
Overall, diseases of despair diagnoses were more common among those with other conditions, like anxiety or schizophrenia.
The team acknowledged an estimated 87 million working adults in the US are uninsured or underinsured, making it hard to gauge the true scope of the problem.
Highmark members are also concentrated in Pennsylvania, West Virginia and Delaware – states that are said to have been disproportionately affected by deaths of despair.
Nevertheless, the team stressed: “While the opioid crisis remains a top public health priority, parallel rises in alcohol-related diagnoses and suicidality must be concurrently addressed.”
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