Drug deaths fall for first time in nearly 20 years, buoying US life expectancy

Deaths from drug overdoses dropped slightly in 2018, a first in nearly two decades as the nation confronts a massive opioid epidemic.

The reduction in drug overdose deaths, reported Thursday by the Centers for Disease Control and Prevention, of 4.1%, helped to slightly bump up life expectancy from 78.6 years in 2017 to 78.7 years in 2018.

Prior to that, life expectancy had been falling slightly or remained the same for three years in a row. The shift alarmed public health experts because wealthy countries typically see an upward trend in life expectancy thanks to medical developments and better public health.

It will take several years before scientists will be able to tell whether 2017 was the year that the opioid epidemic peaked or whether the 2018 data are only a blip in what is otherwise a continued upward trend. Still, the news Thursday offers President Trump a boost during his reelection campaign as Democrats criticize his administration for not going further in fighting the crisis.

"This news is a real victory, and it should be a source of encouragement for all Americans who have been committed to connecting people struggling with substance abuse to treatment and recovery," Health and Human Services Secretary Alex Azar said in a statement. "The drop in overdose deaths shows that the president’s new level of focus on the opioid crisis, and the administration’s science- and community-based efforts to combat it, are beginning to make a significant difference."

The reports released Thursday show that, in 2018, life expectancy increased by 0.1 years, or slightly more than a month, for both men and women, whose expected lifespans grew to 76.2 years and 81.2 years, respectively. The upward shift happened not only thanks to a reduction in drug overdose deaths, from 70,237 deaths in 2017 to 67,367 in 2018, but also because fewer people died from cancer and chronic lower respiratory diseases.

Still, the fight against drug deaths is far from over. Deaths from "unintentional injuries," which includes drug overdoses, remained the third-leading cause of death, after heart disease and cancer, just as it was in 2017. The death toll from opioids, of 46,802 people, is still high, and the data show another troubling trend: that suicides rose from 47,173 in 2017 to 48,344 in 2018.

Progress on drug overdoses was also uneven by state. California, Delaware, Missouri, New Jersey, and South Carolina all had a higher number of deaths from drugs in 2018 than in 2017.

The authors of the report found that the rate of deaths from fentanyl, a highly potent opioid made in a lab, rose from 28,466 deaths in 2017 to 31,335 deaths in 2018. Cocaine deaths, too, have surged since 2012, reaching 14,666 in 2018. A Washington Examiner analysis of cocaine data revealed that the drug is more deadly today because people are taking it with opioids, often unknowingly. Meth deaths have increased fivefold since 2012.

Azar called the meth trend "disturbing," saying the administration's work against drug overdoses was "far from finished."

Another reason life expectancy wasn't higher was that the death toll from flu and pneumonia rose in 2018, as did deaths from malnutrition.

The last time life expectancy in America showed a downward slope, like it did from 2014 to 2017, was during World War I, when a Spanish flu pandemic tore through the population, resulting in 50 million deaths across the Earth. Life expectancy fell by a much higher magnitude then, by about a dozen years.

The latest data on mortality from the CDC did not contain a breakdown by race, but mortality in past years has been rising among whites, driven by drug and alcohol poisoning, suicide, chronic liver disease, and cirrhosis. The factors driving the rise in mortality for whites are complex, but the trend was widely referred to in news reports and among educational circles as "deaths of despair," with many researchers attributing them to economic anxiety.

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