Colin AngusMar 2, 2023

We've got a new paper out comparing alcohol, drug and suicide mortality (so-called 'deaths of despair') in the USA and the UK nations during the first 2 years of the pandemic in Public Health.

https://doi.org/10.1016/j.puhe.2023.02.019

We used publicly available mortality data to calculate age-standardised mortality rates for each cause and country 2001-2021. The grey area represents the pandemic period.

Americans might want to look away now.

Show threadColin AngusMar 2, 2023
Among the interesting things we found were the fact that in spite of dire predictions at the start of the pandemic that we'd see a huge rise in deaths by suicide, these fears appear to have been misplaced. Suicide rates fell below the pre-pandemic trends everywhere except perhaps Northern Ireland (although as a smaller nation, their figures are noisier so harder to interpret).
Show threadColin AngusMar 2, 2023
Alcohol deaths showed a similarly coherent, but less encouraging pattern, rising everywhere in 2020. There was, however, some variation in the scale of these rises. US numbers have risen starkly, while England & Wales have seen the biggest relative increase in the UK, but remain some way below current levels in Scotland and Northern Ireland.
Show threadColin AngusMar 2, 2023

For drug-related deaths the picture is much less consistent. Scotland and the US have been on very similar alarming upward trajectories of drug deaths, as we've explored in a previous pre-print: https://doi.org/10.1101/2022.10.10.22280916

But while drug deaths in the US have accelerated even faster in the last 2 years, in Scotland the rise appears to have halted.

Show threadColin Angus
These big differences in the trends between alcohol, drug and suicide deaths is rather at odds with the trend to combine them into a single 'deaths of despair' narrative. Meanwhile the between-country differences might invite a temptation to link these deaths to the pandemic response. But why then have deaths by suicide fallen, while alcohol deaths have risen everywhere, yet drug deaths have such different patterns?
Mar 2, 2023 at 4:15pmWeb
Show threadColin AngusMar 2, 2023

We also looked at age-specific trends. These tell some interesting stores about age differences in increased deaths.

In England the rise in alcohol deaths stands out across all ages, while in Scotland it's clearest in older ages (that had previously seen big falls), while drug deaths are still rising in older ages but falling in younger adults.

The US data, meanwhile, is just horrifying.

Show threadColin AngusMar 2, 2023

We argue that this emphasises the need for tailored public health policy approaches that reflect the specific harms and underlying causes in each place. e.g. the nature and causes of the Scottish and US drug deaths epidemics are very different, even though the mortality impacts were similar until 2020.

And the US urgently needs to do *something* about drug and alcohol deaths.

#RStats code to replicate all this analysis can be found here: https://github.com/VictimOfMaths/DeathsOfDespair/blob/master/DataInsight/DodPandemicPaperFinal.r

DeathsOfDespair/DodPandemicPaperFinal.r at master · VictimOfMaths/DeathsOfDespair

Analysis of deaths from alcohol-specific causes, drugs and suicide - DeathsOfDespair/DodPandemicPaperFinal.r at master · VictimOfMaths/DeathsOfDespair

GitHub
Show threadColin AngusMar 2, 2023
And huge credit to my fabulous co-authors Charlotte Buckley, @AndreaTilstra and @drjenndowd
Show threadAllen StenhausMar 2, 2023

@VictimOfMaths The War on Drugs leaves too many with legitimate medical need seeking illegal & unreliable alternative sources for controlled substances that are currently unavailable & have been for quite some time. No doubt that is playing a massive role.

In the past, overprescription of narcotics for even mild pain made it so those in severe pain couldn't get strong enough meds & they would often add alcohol to the mix.

Restrictions make these deaths more common.