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'Wake-up call': Iowa deaths by drugs, alcohol and suicide to jump 36 percent by 2025

Globe Gazette - 11/28/2017

A meteoric increase in deaths by drugs, alcohol and suicide in Iowa is expected to slow during the next 10 years but still increase by more than one-third by 2025.

Iowa's drug, alcohol and suicide death rate, which increased 177 percent from 1999 to 2015, will rise by 36 percent from 2015 to 2025, according to Pain in the Nation, a report from the Trust for America's Health and the Well Being Trust.

The 200-page report says those three causes could account for 46 deaths per 100,000 deaths in Iowa by 2025 - more than 1,400 people.

That compares with 33.9 per 100,000 in 2015 and 16.6 per 100,000 in 1999.

Iowa is not alone.

If trends continue, about 1.6 million people in the United States will die from drugs, alcohol and suicides during the next 10 years - a 60 percent increase from the 1999 to 2015 period, according to the report.

Well-being crisis

The report, based on data from the Centers for Disease Control and Prevention, was prepared for Trust for America's Health. The nonprofit, nonpartisan organization works to protect health by making disease prevention a national priority. Data also was taken from the Well Being Trust, a national foundation dedicated to advancing mental, social and spiritual health.

The report calls the projections a "wake-up call" of a serious well-being crisis.

"In stark terms, they are signals of serious underlying concerns facing too many Americans - about pain, despair, disconnection and lack of opportunity - and the urgent need to address them," according to the report.

The authors also warn that their projections might be conservative. That's because America's opioid crisis continues, along with a rapid rise in the use of heroin and fentanyl.

Although the crises have received considerable attention, "actions that have been taken to date are severely inadequate," according to the report.

Iowa rankings

Here's where Iowa stands in relationship to the rest of the country:

Nationally, drug overdose deaths tripled between 2000 and 2015, with a total of 52,400 deaths in 2015. Iowa's rate in 2015 was 9.9 per 100,000 people - fifth lowest in the nation.

State officials reported this month that Iowa maintains one of the lowest overall rates of illegal drug use in the nation at 6.27 percent - below the national average of 9.77 percent and second only to South Dakota's 5.82 percent.

However, overdose deaths caused primarily by opioids totaled 86 in 2016 (70 prescription and 16 heroin), while opioid-related overdose deaths rose to an all-time high of 180, according to Iowa data.

Rural communities have been particularly affected by the opioid and suicide crises in the past 15 years. Before 2000, rates of drug overdoses in rural communities had been lower than in metro areas of the country. Drug overdose death rates increased sevenfold in rural America.

Nationally, alcohol-induced deaths rose to a 35-year high of 33,200 in 2015. That doesn't include deaths from injury and violence in which alcohol was a factor. Iowa's alcohol-induced death rate was 11 per 100,000 in 2015, the 27th highest in the nation.

Nationally, the suicide death rate increased 28 percent from 2000 to 2015, when 44,000 Americans took their own lives. The suicide rate in rural areas was 40 percent higher than in metro areas. Iowa's rate was 13.9 per 100,000 in 2015, the 15th lowest in the country.

Last year, 44.7 million American adults experienced a mental illness, 20.1 million experienced a substance use disorder and 8.2 million experienced both - numbers that probably underestimate the scope of the problem, because of issues with stigma. Only about 1 in 10 Americans with substance use disorder receive recommended treatment, the report said.

Resilience needed

If there is good news, it's that mental health professionals know a lot about what works and what can make a difference.

What works is part of a "national resilience strategy" of 60 research-based policies, practices and programs that could reduce substance misuse and suicide.

Iowa has implemented some of the policies, such as substance abuse screening during pregnancy and for newborns.

The state also complies with the Individuals with Disabilities Education Act that helps provide screening services for children from birth to age 2 for disabilities and helps connect families with early intervention services.

Iowa also gives prescribers and dispensers access to Naloxone, which rapidly reverses the effects of an opioid overdose, allows lay people to administer the antidote and does not prosecute individuals for its possession.

However, the state falls short of other measures the report recommends, such as prescription drug monitoring.

Iowa shares interstate prescription information but doesn't require prescribers or dispensers to monitor prescriptions. Neither does it require suicide prevention training for school personnel.


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