‘Deaths of despair’ on rise in Canada, following U.S. trend

TORONTO • The “deaths of despair” causing life expectancy to fall in the U.S. — drug overdoses, suicide and alcohol abuse — could have the same impact here, says a paper in the Canadian Medical Association Journal.

“There are some signs which are pointing in the same direction,” said Juergen Rehm of Toronto’s Centre for Addiction and Mental Health. “We find the same (trends), to a much lesser degree, in Canada.”

Rehm said life expectancy in the U.S. has begun to decline slightly for the first time since the Second World War. The increased deaths are heavily correlated to areas with poorer and more rural people, said Rehm.

“Ninety per cent of what’s happening with deaths of despair in the United States is happening in rural America,” he said. “You cannot let large parts of a country have a net loss in salary over 10 to 15 years and expect those people to be as happy and as clear as before.”

In a commentary in the journal, Rehm said a similar trend appears to be taking hold in Canada. Overdose deaths have been increasing, to about 4,000 in 2017.

“They used to be under 2,000 not that long ago,” Rehm said.

Deaths from alcohol-related diseases such as cirrhosis of the liver are also increasing.

“Our life expectancy is increasing, but it’s plateauing.”

Findings from a separate paper in the same journal back him up.

The Public Health Agency of Canada says the average Canadian lifespan is 82 years — still the 10th-longest in the world. But it’s up only slightly from 81 years in 2006.

The same study finds the death rate from mental and substance use disorders increased by 11 per cent from 2006 to 2016.

Rehm said there are ways for Canada to avoid a decline in life expectancy driven by deaths of despair.

Don’t make booze cheap, for one. Rehm refers to dozens of studies linking price and availability of alcohol to its abuse.

Rehm also suggested doctors need to re-examine why and when they prescribe opioid painkillers.