American deaths from suicide, medicines outnumber diabetes



MONDAY, August 27, 2018 (HealthDay News) – More Americans are now dying of suicide and drug overdoses in combination with diabetes, a new report reveals.

In 2016, there were 29 deaths from suicide or drug overdose per 100,000 Americans, compared with just under 25 deaths per 100,000 of diabetes. That was more than two years earlier, when the mortality figures for the two causes were comparable, according to the researchers.

The change is striking, said Ian Rockett, lead author of the report and emeritus professor of epidemiology at West Virginia University.

"Death by suicide and overdose of drugs is increasing, and they happen at a younger age than diabetes deaths," noted Rockett.

He said the findings help illustrate the extent of not only the country's opioid epidemic, but also the rising number of suicides.

Diabetes is a common chronic disease and ranks seventh in the United States. If more Americans are now dying of suicide and drug overdose, Cloudett believes this is a wake-up call.

He and his colleagues are arguing for a new way of seeing deaths from overdoses: those deaths, they say, should be regarded as deaths from "self-injury", just like suicide.

First, some drug overdose deaths are deliberate – but it is not clear how much. In the absence of a suicide note, it is difficult for coroners to determine the intention, Rockett said.

Beyond that, even if the deceased was not going to take a lethal drug dose, that death can still be seen as the result of self-injury, according to Rockett.

"These deaths are not really accidents," he said. "They are self-damaging."

The point, Rockett emphasizes, is not to "blame the victims".

Instead, he said, the point is to emphasize the fact that people who die of suicide or overdose of drugs often have a similar history – including trauma, untreated depression and lack of social support.

"We are trying to point out that this is an even bigger problem than we realize," Rockett said.

The national suicide rate increased by 24 percent between 1999 and 2014 – from 10.5 deaths per 100,000 people to 13 per 100,000, according to the US Centers for Disease Control and Prevention.

Meanwhile, the opioid toll continues to grow. Recent research has shown a flattening of US abuse of prescription-only opioid painkillers such as Vicodin, OxyContin and codeine. But abuse of illegal opioids is increasing. That includes heroin and unlawfully made fentanyl, a synthetic opioid.

And, in general, deaths from opioids are still rising.

The deaths from heroin have increased enormously in recent years. But it is illegally made fentanyl that has emerged as the biggest concern. Earlier this year, researchers reported that synthetic opioids (mostly fentanyl) accounted for 30 percent of US deaths due to overdose in 2016. That was an increase of about 8 percent in 2010.

A total of 19,400 Americans died of overdoses with synthetic opioids in 2016, while according to a government study more than 13,200 died of a heroin overdose.

These latest findings, published online August 27 in the journal Injury prevention, are based on death certificate data from the CDC.

Dr. Mark Olfson is a professor of psychiatry at Columbia University in New York City. He said that it could be useful to see deaths from suicide and drug overdose as one group.

"A broad acceptance of the concept of self-injury could fuel much-needed reforms in clinical care by focusing on underlying risks that kill drug use itself intoxication and suicide," said Olfson, who was not involved in new study.

That would mean more cross-over in patient care, he explained: more screening for substance abuse in patients being treated for depression or other mental disorders; and more attention to the general mental health of people in the treatment of drug abuse.

At present, such coordination is patchy. For example, if patients are treated in an ER for an overdose of drugs, they may or may not be referred to mental health services, Rockett noted.

In some cases, those services may not even be immediately available, he said.

For example, in areas where the opioid epidemic is most acute – including rural communities – people may not have professional mental health professionals nearby.

Rockett also pointed to the larger picture: social factors, including unemployment and income equality, play an important role in both suicide and drug overdose.

These are factors that will not be easily changed, he said, but they need to be addressed.

More information

The US drug abuse and mental health agency has resources to find treatment.

SOURCES: Ian Rockett, Ph.D., M.P.H., emeritus professor, epidemiology, West Virginia University School of Public Health, Morgantown, W.V .; Mark Olfson, M.D., M.P.H., professor, psychiatry and epidemiology, Columbia University Medical Center, and research psychiatrist, New York State Psychiatric Institute, New York City; August 27, 2018, Injury preventiononline


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