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Thursday, February 28, 2019

By Staff Reports

 

In the most comprehensive international comparison of its kind, a USC study found that the United States has the highest drug overdose death rates among a set of high-income countries.

Drug overdose mortality has reached unprecedented levels in the United States, more than tripling over the past two decades. But is this a uniquely American epidemic, or are other high-income countries facing a similar crisis?

“The United States is experiencing a drug overdose epidemic of unprecedented magnitude, not only judging by its own history but also compared to the experiences of other high-income countries,” said study author Jessica Ho, assistant professor at the USC Leonard Davis School of Gerontology. “For over a decade now, the United States has had the highest drug overdose mortality among its peer countries.”

The study, published February 21 in Population and Development Review, found that drug overdose death rates in the United States are 3.5 times higher on average when compared to 17 other high-income counties. The study is the first to demonstrate that the drug overdose epidemic is contributing to the widening gap in life expectancy between the United States and other high-income countries.

By 2013, drug overdose accounted for 12 percent and 8 percent of the average life expectancy gap for men and women, respectively, between the United States and other high-income countries. Without drug overdose deaths, the increase in this gap between 2003 and 2013 would have been smaller: one-fifth smaller for men and one-third smaller for women.

“The American epidemic has important consequences for international comparisons of life expectancy. While the United States is not alone in experiencing increases in drug overdose mortality, the magnitude of the differences in levels of drug overdose mortality is staggering,” said Ho.

“On average, Americans are living 2.6 fewer years than people in other high-income countries. This puts the United States more than a decade behind the life expectancy levels achieved by other high-income countries. American drug overdose deaths are widening this already significant gap and causing us to fall even further behind our peer countries,” Ho said.

A uniquely American phenomenon – but will it stay that way?

Over 70,000 people died from drug overdoses in the United States in 2017, and the National Safety Council announced in January that Americans are now more likely to die of an accidental opioid overdose than in a car crash.

Potential drivers of the country’s strikingly elevated drug overdose mortality levels include health care provision, financing and institutional structures, such as fee-for-service reimbursement systems and tying physician reimbursement to patient satisfaction. Additional factors include a well-documented marketing blitz by the manufacturers of OxyContin, American cultural attitudes towards pain and the medical establishment, and the scarcity of substance abuse treatment in the United States, where only an estimated 10 percent of those with a substance abuse disorder receive treatment.

The USC study utilized data on cause of death from the Human Mortality Database and the World Health Organization Mortality Database for the set of 18 countries, along with additional data from vital statistics agencies in Canada and the United States to produce country-, year-, sex-, and age-specific drug overdose death rates between 1994 and 2015. Deaths from both legal and illegal drugs (not limited to opioids) and deaths of all intents were included.