Diabetes is a known health threat in the US with rates that have reached epidemic proportions in recent years. But now researchers report that another scourge has surpassed them in terms of lethality: suicides and overdose deaths.
Diabetes is officially the seventh leading cause of death nationwide. Self-injury, as the combination of suicide and drug-related deaths is known, killed as many people as diabetes in 2014 and is continuing to accelerate. The main consequence of this uncontrolled crisis will reduce US life expectancy, said Ian Rockett, a professor of epidemiology at West Virginia University in Morgantown.
"Unfortunately, I do not think we can do a good job of wrapping our arms around it," said Rockett, the lead author of a study published in the magazine "Injury Prevention" on Monday. "It's a growing problem."
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As awareness of the dangers of narcotics and prescription painkillers grows, the true extent of the opioid crisis in the US and the path to it has been obscured by the investigation of deaths by medical examiners, the report said. In the absence of a farewell letter, most overdoses are registered as accidents. Suicide rates have increased since 2005, and the most common form of suicide attempt is an overdose of drug use.
"Rising suicide and opioid mortality rates are not really independent," Rockett said in a telephone interview. "If you focus on behavior, most of those deaths are self-harming, we do not want to accuse the victim, but descriptively they belong together."
Keeping them separate obscures the national burden of deaths caused by targeted, self-injurious behaviors, the researchers said. If the scale of the problem is fully understood, public health officials can develop effective ways to intervene in the crisis.
Prevention strategies are successful in other socially complex health issues, including reducing deaths from smoking-related lung cancer, heart disease, HIV and auto accidents. The key is to pinpoint and measure the problem, and then to find the political will to deal with it, they said.
"Without the former, it is impossible to build the latter," the researchers said.
Forensic doctors and coroners should not spend more time investigating suicides, Rockett said. Instead, the two categories should be linked so that the self-injury and associated mental health problems can be more fully explored.
"We have a severe mental health crisis in America that is greatly underestimated. We think of suicides and drug deaths as another phenomenon," he said. "We need to bring mental health to the fore, it's an even bigger problem than people realize."