Last year the Centers for Disease Control and Prevention (CDC) released data revealing that life expectancy in the United States had decreased from 2016 to 2017. True, only by 0.1 percent overall, but the death rate increased by 2.9 percent for those in the 25 to 34 age group. Those 85 and older actually increased their projected lifespans by 1.4 percent.

If those most vulnerable are living longer and those in their prime are dying sooner, something is wrong. What is the cause?

According to a media statement from CDC Director Robert R. Redfield said, “Tragically, this troubling trend is largely driven by deaths from drug overdose and suicide.”

The CDC said that US overdose deaths totaled 70,237, a 9.6 percent increase over 2016. Suicides also increased to 47,173, though that was only a 0.1 percent increase over the previous year.

But are those figures accurate? Could some of those overdose deaths be suicides? Unlike most of the causes of death, death by drug overdose isn’t so clear-cut if they didn’t leave a suicide note. If you die of a drug overdose it can be by accident or by intentional self-harm. For some people with drug use disorders, they may not much care.

After the first rush of euphoria, many drug users keep coming back not for the pleasure but for the surcease of pain caused by withdrawal. That’s why more addicts don’t seek drug abuse treatment: they can’t face that pain.

Eventually, their life can degrade to just two things: finding drugs and using drugs. At that point, the risk of overdosing and getting off the merry-go-round for good might even seem appealing.

Some people, still adhering to the morality/immorality argument of drug addiction, maintain that any illicit drug use is tantamount to attempted suicide, but I’m talking about intent.

If someone takes a much larger dose of a drug than usual, several times as much, it might be deduced that they weren’t weren’t just looking for a bigger high but attempting to overdose and die. Illicit drug users, however, are not known for their good decision-making skills.

The widespread use of fentanyl to lace or even replace other drugs complicates matters further. Fentanyl is hundreds of time stronger than heroin, morphine, oxycodone and every other drug on the market (except for carfentanil, which is itself hundreds of times stronger than fentanyl and is primarily used for large animal tranquilizing).

Fentanyl, however, is much easier to smuggle and obtain than oxycodone because of the government crackdown on diversion and pill mills, and much cheaper, so drug dealers and their suppliers press it into pill form or add it to existing supplies of other drugs to stretch their supplies and meet consumer demand.

If the dealer or his supplier puts just a little too much fentanyl in the mix, an accidental overdose is more than possible. The evidence suggests that’s what happened with rock stars Tom Petty and Prince, who likely took opioids for pain. Demi Lovato, who survived her own overdose, likely took drugs because of her bipolar disorder, bullying, and body image problems.

Why does it matter? Because not all overdoses are fatal. If it was a suicide attempt, they might try again, and merely giving them a dose of Narcan (naloxone) won’t solve anything in the long run. They need treatment for suicide prevention as much as treatment for DUD. Probably they need both: dual diagnosis treatment.

For many users, drug use is not so much a choice as a sign of a mental health problem. The two often co-occur, known as dual diagnosis, with drug use an attempt to self-medicate for the mental health problem.

Mental illness, suicide, and drug addiction all have their stigmas. We must ensure that these stigmas don’t prevent treatment.

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