Despair, Substance Abuse, & Suicide Increasing

Woman on the shore

Within the last few years, life expectancy has started decreasing in America. Currently, suicide and drug overdose are one of the top leading causes of death in America [2]. Researchers discovered that this is partially due to the increased amount of “deaths of despair” [1]. Deaths of despair is a label that researchers have given to deaths caused by suicide or alcohol and substance abuse that leads to an overdose.

Causes of “Deaths of Despair” Suicides

These conditions are likely referred to as “deaths of despair” because alcohol, substance abuse, and suicide are linked to distress of some kind. Whether it be emotional or physical pain, substance use, and suicide are often attempts to cope with unbearable distress.

Despair is when someone loses hope. Signs of this are not having a sense of purpose in life, feeling worthless, having little or no future goals, or feeling rejected by society [1]. This feeling can progress into significant mental health diagnoses, such as depression and anxiety [1].

There are certain groups of people who have been impacted by this the most. People ages 55-74 showed the biggest increase in substance abuse. Individuals 18 and under had a significant increase in suicide attempts and suicidal thoughts [1]. Among both of these groups, men and those with government-issued health care were more likely to struggle.

While each person’s situation is different, there are some common societal stressors that are linked to increased despair among these populations. Some of these factors include decreased income, lower marriage rates, and an increased number of single parent homes [1].

These societal issues are important because mental health issues, such as addiction and suicide, are stigmatized and judged. These judgments can lead to these conditions being viewed as an individual problem. Research is showing that it is actually a societal problem [1].

It will take a lot of work to change all of the societal issues that contribute to these “deaths of despair.” While we work on repairing the societal issues that play a part in their development, it is unlikely that the issue of suicide and addiction will be resolved. As long as people continue experiencing economic deprivation, disconnection, and discrimination, Americans will continue to struggle with fatal mental health conditions.

However, there are prevention and treatment methods that can help. Here are some ideas on possible strategies for reducing deaths of despair:

Suicide Prevention

Group of people supporting someone contemplating suicideThere are a few ways to prevent suicide. These are:

  • Implementing screening tools at health facilities, such as the doctor’s office or in the emergency room
  • Health care facilities, including mental health providers, can use electronic health records to identify individuals at risk for suicide.
  • Increasing support for people who are showing signs of being at risk or who are expressing suicidal thoughts or intent. Support can be from mental health professionals, a suicide hotline, family members, or friends. It is important for people who are at risk not to be isolated and have access to resources.

Substance Use Prevention

Like suicide prevention, implementing assessments into routine and emergency healthcare visits is one way to identify people at risk for substance abuse. Identifying this risk and then providing proper referrals to treatment can be lifesaving.

Referral to Mental Health Treatment

Addiction and suicide are a reflection of underlying mental health issues. Providing referrals for people struggling with mental health issues is an important aspect of reducing deaths of despair. Referral to a mental health professional or treatment center can give someone the tools they need to recover from addiction or resolve suicidal thoughts.

While these methods are bandaids for a systemic issue that is contributing to millions of deaths, they are effective [2]. This is our best shot to save lives while we work to make our society healthier for everyone.


[1] Brignone, E. George, D.R., Sinoway, L., Katz, C., Sauder, C., Murray, A., Gladden, R., Kraschnewski, J.L. (2020). Trends in the diagnosis of diseases of despair in the United States, 2009–2018: A retrospective cohort study. BMJ Open, 10, 1-11. doi:10.1136/ bmjopen-2020-037679

[2] National Institute of Mental Health. (2019, July). Suicide Prevention.

About the Author:

Samantha Bothwell PhotoSamantha Bothwell, LMFT, is a licensed Marriage and Family Therapist, writer, explorer, and lipstick aficionado. She became a therapist after doing her own healing work so she could become whole after spending many years living with her mind and body disconnected. She has focused her clinical work to support the healing process of survivors of sexual violence and eating disorders. She is passionate about guiding people in their return to their truest Self so they can live their most authentic, peaceful life.

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on December 8, 2020
Reviewed by Jacquelyn Ekern, MS, LPC on December 8, 2020
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About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.