The United States faces a dual crisis of fatal drug overdoses linked to addiction and rising suicide rates tied to mental health struggles. This alarming trend reveals a growing sense of despair among individuals nationwide. Suicide rates have steadily climbed across all demographics, increasing nearly 28% from 1999 to 2016, with 45,000 Americans dying by suicide in 2016, making it the 10th leading cause of death that year.
Alcohol-related deaths and drug overdoses have also surged. In 2016 alone, 142,000 Americans lost their lives due to alcohol-related causes, drug overdoses, or suicide—equivalent to one death every four minutes. The average life expectancy in the U.S. even declined between 2015 and 2016, marking a notable shift after years of improvement.
Hospitalizations for mental health and substance abuse further underscore the scale of the crisis. From 2005 to 2014, these were the only categories of hospital admissions that increased, with opioid-related cases driving much of this rise.
The country is grappling with a profound public health emergency related to alcohol, drug misuse, and mental health, evidenced by the climbing suicide rates. If this crisis were rooted in infectious disease, it would likely trigger a nationwide response. However, due to the stigma surrounding mental health and addiction, these issues are often ignored or met with victim-blaming, making it difficult for the government to mount an adequate, comprehensive response.
The Link Between Mental Health and Addiction
Understanding the relationship between addiction and mental health is crucial, as they represent interconnected pieces of a larger public health puzzle.
Historically, a clear distinction was made between mental health issues and addiction, treating them as separate, unrelated conditions. However, in the 21st century, we recognize that these two domains are much more intertwined than previously understood. Proper treatment of both mental illness and addiction necessitates a comprehensive understanding of their impact on individuals.
When a person experiences addiction alongside a mental health disorder, such as depression, bipolar disorder, or anxiety, it is referred to as “dual diagnosis” or “co-occurring disorder.” Either condition can develop first; however, it is common for individuals with mental illness to self-medicate using drugs or alcohol to alleviate their symptoms. Unfortunately, research indicates that substance use can exacerbate mental health symptoms, leading to a destructive cycle of worsening mental health and increasing substance abuse.
Both addiction and mental illness independently create challenges for maintaining a stable life, but their combination complicates matters further. According to HelpGuide.org, “When a mental health problem goes untreated, the substance abuse problem usually gets worse. And when alcohol or drug abuse increases, mental health problems typically worsen.” Ignoring these issues rarely leads to improvement; professional treatment is essential for achieving stability and well-being.
A 2014 National Survey on Drug Use and Health revealed that approximately 7.9 million people in the U.S. experience both a mental disorder and substance use disorder simultaneously. Of these individuals, over half—around 4.1 million—are men. Additionally, the survey found that 45% of people with addiction also have a co-occurring mental illness.
The most effective approach to treating co-occurring addiction and mental health disorders is through individualized, integrated care, delivered by clinicians experienced in the complexities of addiction as a disease. A prevalent misconception is that individuals must “hit rock bottom” before they can begin the recovery process; however, this dangerous perspective can lead to life-threatening consequences.
The narrative that individuals need to reach a desperate state before seeking help can be counterproductive to effective treatment. Public perception must align with the medical understanding of addiction as a disease. Alarmingly, a 2014 study found that 43% of adults in the U.S. opposed providing individuals with addiction the same medical insurance benefits as those with other illnesses, while 21% held similar views about mental illness. Moreover, 59% of people believe treatment options for drug addiction are ineffective, and 41% share the same belief regarding mental health treatment.
The Human Cost of the Opioid Epidemic
In the past two decades, the opioid crisis has reached alarming levels, with projections indicating that the toll will continue to escalate in the coming years. The Centers for Disease Control and Prevention reported a 22% increase in drug overdoses in the United States from 2016 to 2017, rising from nearly 53,000 to just over 64,000. This spike in overdose deaths, while significant, pales in comparison to the broader trend observed over the past several decades, especially in the last five years.
According to the National Institute on Drug Abuse, annual opioid overdose deaths have surged from just over 2,500 in 2013 to almost 30,000 in 2018, representing a staggering increase of 1,200% in just five years.
The Human Cost of the Opioid Epidemic
Research indicates that the opioid crisis has had a profound effect on the American workforce. Higher rates of opioid prescriptions correlate with decreased labor force participation across various counties in the U.S. It is estimated that opioids account for up to 43% of the decline in labor force participation among men over the past 15 years. The Council of Economic Advisers suggests that the opioid crisis could be costing the economy over $500 billion annually, nearly 3% of the GDP. Surveys reveal that 80% of employers are concerned about inappropriate opioid use among employees, while 70% report experiencing direct impacts from prescription drug misuse in the workplace.
Fortunately, employers and organizations can take steps to mitigate this issue through robust workplace policies, education, health benefit programs, and effective management practices. Strategies include regular drug testing—which has been linked to a 51% reduction in workplace injuries and a 12% decrease in compensation claims—providing training on Employee Assistance Programs, reviewing workplace drug policies and benefits plans for addiction treatment, conducting workshops to help identify drug use, and educating employees about the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA). Employer-supported and monitored treatment has been shown to result in longer treatment durations and improvements in employment-related issues.
While all other drugs, except for methadone, have seen increases in use, none have approached the severity of the opioid crisis. This growing mental health crisis in America has opened up discussions about the rising number of drug-related overdoses across the nation. To address the escalating rates of suicide and drug-related deaths in the U.S., a comprehensive, nationwide call to action is needed. Below are some strategies that states and local communities can implement to reduce deaths from suicide and drug overdose.
Improved Mental Health Screening
Implementing screening for substance abuse, suicidal ideation, and other mental health indicators is an essential measure that healthcare systems and businesses can adopt to help save lives. The Substance Abuse and Mental Health Services Administration (SAMHSA) has introduced a method known as SBIRT (Screening, Brief Intervention, and Referral to Treatment), which has been associated with reduced healthcare costs and lower rates of substance misuse. More healthcare organizations should integrate this tool into their routine practices to effectively identify and support individuals facing suicidal thoughts or substance abuse challenges.
Reducing Access to Lethal Means
A proven strategy for decreasing access to lethal means—such as medications or firearms—is the CALM approach (Counseling on Access to Lethal Means). A study conducted in Colorado demonstrated that parents of children at risk for suicide significantly changed their behaviors, leading to a more than 50% increase in the safe storage of medications and firearms. Schools, businesses, and state organizations could play a pivotal role in promoting awareness of this method by distributing relevant information.
Enhancing Awareness and Access to MAT
Medication-Assisted Treatment (MAT) is recognized as one of the National Principles of Care for Substance Abuse. Unfortunately, it still faces stigma, often regarded as a mere band-aid solution that substitutes one drug for another. A study by Blue Cross Blue Shield indicated that, despite a rise in patients diagnosed with opioid use disorder from 2010 to 2016, the proportion receiving MAT did not increase at a similar rate. It is crucial to acknowledge MAT as a credible and effective strategy for addressing addiction. A comprehensive 2012 study on Methadone treatment revealed that MAT for opioid abuse was linked to improved retention rates, reduced mortality, enhanced social functioning, decreased drug use, and an overall better quality of life.
Enhancing Pain Management and Treatment
While it is crucial that patients do not endure unnecessary suffering during recovery, it is equally important for healthcare providers to prescribe painkillers responsibly to prevent the risk of developing a debilitating addiction. The Centers for Disease Control and Prevention (CDC) has established specific guidelines for opioid prescriptions that all physicians should follow, though these guidelines are no longer widely regarded as effective by experts.
Harm Reduction through Prescription Drug Monitoring Programs (PDMPs)
Prescription Drug Monitoring Programs (PDMPs) are effective tools that states can utilize to combat prescription drug diversion and misuse. These databases enable government agencies to track the distribution of medications throughout a state, helping to identify patients who may be engaging in doctor shopping, physicians who might be overprescribing, and patients receiving overlapping prescriptions. Research indicates that states implementing PDMPs have successfully reduced opioid prescription rates by 8% and opioid overdose deaths by 12%.
Expanding Recovery Housing in Rural Areas
Nonprofit organizations operating in rural regions now have a unique opportunity to develop sober living and transitional housing options for individuals recovering from opioid misuse, thanks to a new partnership between the U.S. Department of Health and Human Services and the Department of Agriculture. Announced in February, this initiative allows organizations to apply for and acquire single-family homes from the USDA, transforming them into transitional housing for those in recovery.
According to a USDA spokesperson, the program is currently active and will continue indefinitely, with the agency seeking buyers experienced in transitional housing. Rather than setting specific quantitative targets for recovery housing development, the agency emphasizes that finding the right fit and circumstances for these units is more critical than the number of homes created.
A press release from the Substance Abuse and Mental Health Services Administration (SAMHSA) states that both SAMHSA and the USDA Rural Development office are collaborating to sell single-family properties at a discount to assist individuals in recovery. This partnership, which began in 2018, has seen SAMHSA supplementing grants to enhance the purchasing capacity of the USDA. Additionally, the USDA has introduced a community opioid misuse toolbox, which includes a comprehensive database designed to support community leaders in addressing the opioid crisis in their areas.
“We know that the opioid crisis has severely impacted rural communities, and we must utilize every available partnership to assist these populations,” stated Elinore McCance-Katz, MD, Assistant Secretary for Mental Health and Substance Use at HHS. “Housing plays a critical role in the recovery process for individuals with opioid use disorders.”
In Conclusion
At Sunrise Recovery in Jeffersonville Indiana, we are committed to providing our patients with the highest quality care for their addiction and mental health needs. We prioritize building a supportive network filled with love and resources designed to help individuals liberate themselves from the grips of addiction. To discover more about drug and alcohol rehabilitation services in Indianapolis, please visit our website.
