Pain in the Nation Update: ALCOHOL, DRUG, AND SUICIDE DEATHS IN 2018



Pain in the Nation Update:

May 2020

Mixed Trends in 2018 as Overall Opioid Overdose Deaths Decline, But Deaths Involving Alcohol, Suicide, Synthetic Opioids, and Psychostimulants Continue to Rise.

In 2018, more than 150,000 Americans died from alcohol, drugs, and suicide combined.
The 2018 death rate—46.4 deaths per 100,000—is level with the 2017 rate of 46.6 per
100,000. This is the first time since 1999, when the current data began, that there hasn’t
been an annual increase in the combined figure and the first time in years that there hasn’t
been a sizable increase



Alcohol-induced deaths and suicide deaths continued to rise in 2018, as they have for several years. Alcohol  deaths were up 4 percent in 2018, more than the previous year’s 2  percent rise.

Conversely, suicide was up 2 percent, a smaller increase than the 4 percent in 2017.

However, these trends may all change when researchers look back at 2020.
With major disasters often come an increase in mental health and substance use disorders, as well as
domestic violence and child abuse.
The pandemic of the novel coronavirus (the virus that causes the disease COVID19) has been and is continuing to cause a massive amount of additional stress and trauma across the population, an increase in social isolation, an unprecedented loss of employment and income, disruption of mental health and substance use services, and diversion of funding and resources to meet emergent needs.

All of which have negative effects on mental health, substance use, and well-being in the immediate and, possibly long term.

Some of this is evident already: the number of March 2020 calls to the national mental health crisis hotline was 891 percent higher than in March 2019.

Additionally, certain coping mechanisms and reactions—like higher rates of alcohol and drug consumption, and increased firearm sales—may increase rates of future substance use disorders, drug overdoses, alcohol-induced deaths, and suicides.

This means the policy responses to COVID-19 should include provisions and resources to support the mental and behavioral health of all Americans, should reduce access to lethal suicide means, and should ensure that social supports and health care are available to all.


Trends in Deaths by Suicide:

  •  In 2018, 48,344 Americans died
    as a result of suicide, and 424,041
    Americans died from suicide over the
    past decade (2009–2018).


  •  Suicide rates were 2 percent higher
    in 2018 compared with 2017, and
    rates in 2018 were 25 percent higher
    than 2008. Suicide rates in 2018
    increased almost universally across all
    demographics. The major exception
    is that the suicide rates for adults ages
    18 to 35 and 35 to 54 were stable.


  • Racial/ethnic minority groups all saw
    larger proportional changes in suicide
    rates than Whites in both one-year and
    10-year trends—including 5 percent
    increases among Asians and Blacks,
    and an 8 percent increase among
    Latinos between 2017 and 2018. For
    more on rising suicide among Black
    youth, see the interview with Dr.
    Michael A. Lindsey on page 12.


  • Another key trend is in the method
    of suicide. Suicide by gun and
    suffocation/hanging have both
    increased substantially. All other
    methods, including poisoning/
    overdose have remained stable for the
    past decade. Between 2017 and 2018,
    gun suicides increased 2 percent and
    suffocation/hanging suicides increased
    5 percent, and between 2008 and 2018,
    gun suicides increased 25 percent
    and suffocation/hanging increased
    50 percent. This suggests that policies
    that reduce access to firearms, and
    additional focus and research on ways
    to reduce firearm and suffocation/
    hanging suicides are urgently needed.


  •  Deaths by suicide in 2018 were highest
    among males (23.4 per 100,000),
    those living in rural areas (19.7 per
    100,000), Whites (16.8 per 100,000),
    and American Indians/Alaska Natives
    (14.1 per 100,000). In 2018, 51 percent
    of suicides were by firearm, 29 percent
    were by suffocation/hanging, 13
    percent were by poisoning/overdose,
    and 8 percent were by other methods.