Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century (original) (raw)

“…Frequencies of dual diagnosis comorbidities (having an Axis 1 mental illness with a concurrent substance disorder) were very high in both study populations (80% to 91%, respectively). The densities and patterns of dual diagnoses comorbidities, and racial/age demographics of patients with opioid use disorders found in the present study were also consistent with several urban clinical samples and large scale epidemiological surveys,2, 7, 8, 21, 22, 23, 24, 25 indicating the present findings are likely generalizable to many addiction treatment settings. Notably, the rates of comorbid alcohol use disorders among patients with opioid use disorders found in our sample (41%) were comparable to recent population data showing that 58% of patients with opioid use disorders have 12‐month prevalence rates of alcohol abuse or dependence 25…”

Section: Discussionsupporting

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“…Frequencies of dual diagnosis comorbidities (having an Axis 1 mental illness with a concurrent substance disorder) were very high in both study populations (80% to 91%, respectively). The densities and patterns of dual diagnoses comorbidities, and racial/age demographics of patients with opioid use disorders found in the present study were also consistent with several urban clinical samples and large scale epidemiological surveys,2, 7, 8, 21, 22, 23, 24, 25 indicating the present findings are likely generalizable to many addiction treatment settings. Notably, the rates of comorbid alcohol use disorders among patients with opioid use disorders found in our sample (41%) were comparable to recent population data showing that 58% of patients with opioid use disorders have 12‐month prevalence rates of alcohol abuse or dependence 25…”

Section: Discussionsupporting

“…Although the health, economic, and social consequences of the prescription opioid epidemic are broad,7, 8 people with mental illness and non‐opioid addictions show disproportionate risk of suffering serious complications of increased access to prescription opioids 9, 10, 11, 12. Pre‐existing mental illness is major risk factor for acquisition of opioid use disorders, and non‐medical opioid use that escalates to addiction is a risk factor for onset of mental illness 13.…”

Section: Introductionmentioning

“…Virchow, writing in the 19 th century, stated that "If disease is the expression of individual life under unfavorable conditions, then epidemics are the symptom of major disturbances in society" (Virchow, 1849). The mortality pattern described by Case and Deaton (Case and Deaton, 2015) could be therefore understood as the symptom for other major disturbances, the social upheaval we described above. Health data, which is routinely collected, can serve as a marker of this social upheaval and signal areas with increased distress where social and public health interventions may be targeted.…”

Section: Resultsmentioning

“…In 2015 Case and Deaton reported an increase in the mortality rate of middle-aged non-Hispanic white Americans (Case and Deaton, 2015). From 1999 to 2013 an increase in all-cause mortality of 33.9 per 100,000 was observed among non-Hispanic whites, while a decrease was observed among other racial/ethnic groups.…”

Section: Introductionmentioning

“…The thinking may have gone along the lines of, BWow, we can pay for a few prescriptions and not have to bother with all that biobehavioral stuff!^But we have belatedly recognized that the worst man-made epidemic in modern medical history related to the over-prescription of opioids is very tough to reverse. And the human and financial costs of this epidemic, including dramatically increasing mortality amongst middle-aged whites, 5 should be a clarion call to deliver more effective alternatives to opioids.…”

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