A massive increase in drug overdoses is ripping the country apart
What killed Americans in 2020?
A fascinating, if grim, chart from the Lyman Stone paints an extraordinary picture. Based on data from the Center for Disease Control and Prevention (CDC), it shows the year-on-year change in various external causes of death.
The main “external causes” are suicide, homicide, motor vehicle accidents and drug overdoses. They exclude diseases and other medical conditions. Therefore the chart does not show the deaths caused directly by Covid-19.
But what about the indirect impacts? Many people feared that the economic hardship and social isolation caused by the pandemic and the lockdowns would manifest in higher levels of suicide. But the evidence for that is thin. Certainly, there is scant indication of it in the CDC data.
What we do so see, however, is a massive increase in drug overdoses. So could these be concealing a hidden rise in suicides? Probably not. Stone points out that accidental overdoses are distinguished from deliberate ones and the latter is included in the suicide figures. It could be that errors are being made in establishing intention, but why would there be an increase in one method of suicide and not the others?
Furthermore, the rising trend in drug overdoses was well-established before the pandemic. And it’s not hard to find a cause for that: America’s opioid epidemic. In particular, there’s the latest acute phase of the crisis, the surge in deaths caused by the most potent opioids — principally, fentanyl.
A chart from a VoxEU article by David Cutler and Edward Glaeser makes the trend clear:
There’s a debate as to whether the opioid epidemic was originally caused by pull or push factors. In other words, was the key factor an increase in demand for painkillers or was it an increase in supply?
Cutler and Glaeser lean heavily towards the supply side. Though opioids are used to treat physical pain and misused for other reasons; the authors note that there was no increase in the relevant medical conditions that might support a demand-led explanation for the rise of addiction and deaths. Nor was there a sufficient fall in levels of life satisfaction during the key period.
What does coincide with the origins of the epidemic, however, is the marketing of new legal opioids followed by the opportunistic expansion of the illegal trade. Furthermore, the authors argue, this has all happened before with previous pharmaceutical innovations.
Will we ever learn?