‘Deaths of despair’: An American epidemic

“Deaths of despair” sound like something that would be found in miserable, wretched places — refugee camps, war-torn cities, famine-wracked villages in povertystricken countries. In fact, the term has emerged to describe a crisis in one of the most advanced societies on the planet — ours.

The United States is in the grip of two lethal epidemics: suicides and drug overdoses. The deaths of designer Kate Spade and TV personality Anthony Bourdain alerted Americans to the rising number of people taking their own lives. Suicides have risen by 30 percent since 1999 — amounting to nearly 45,000 in 2016.

Fatal drug overdoses also have soared. In 1999, they claimed some 17,000 lives; in 2016, the number exceeded 64,000. The biggest increase involves opioids, including prescription painkillers, heroin and the powerful synthetic compound fentanyl.

These are staggering figures. On a typical day in this country, some 175 people die of drug overdoses and 123 by their own hand. That’s one “death by despair” every five minutes. And much of this is happening without provoking an urgent public response.

If hundreds of our fellow citizens were dying every day from terrorist attacks or Ebola, the reaction would be far different. The reason for the relative silence is that we have no simple, quick ways to combat these scourges. They kill one person at a time, often out of sight of anyone but those closest to them.

But a lack of ready solutions is no excuse for inattention or inaction. Drunk driving was once seen as a fact of life, but growing public awareness and assorted policy changes have drastically reduced the number of traffic deaths involving alcoholimpaired drivers.

What can be done about suicides? Wider knowledge of risk factors and greater access to mental health treatment would ensure help to those who feel life has nothing to offer. Better practices for storing guns, by voluntary decision or legal mandate, would keep the most common method out of some hands.

The overdose problem has been addressed by efforts to reduce the number of prescriptions written for opioid painkillers, which declined by 10 percent last year alone. The Affordable Care Act, for all its flaws, gave millions of people access to drug treatment. In April, U.S. Surgeon General Jerome Adams issued a rare advisory, urging Americans to get and carry naloxone, which reverses opioid overdoses, in case they encounter someone in urgent need.

New York Mayor Bill de Blasio has proposed opening “supervised injection centers” where drug users can shoot up in clean facilities staffed with medical personnel. The U.S. Department of Justice, however, regards this approach as flouting the law.

The fact that no one has any magic cure for either epidemic shouldn’t stop us from searching more aggressively for multiple partial cures. Both epidemics demand far more attention from policymakers, and they are starting to get it. Last year, a presidential commission chaired by former New Jersey Gov. Chris Christie offered more than 50 proposals on how to combat opioid abuse.

House Speaker Paul Ryan is touting a raft of bills that he said would not only “stem the flow of opioids into our country” but “change the way opioids are prescribed and encourage non-opioid treatments.” A House subcommittee has approved a bill to establish a new three-digit dialing code (a la 911), for “a national suicide prevention and mental health crisis hotline system.”

What is it about life in modern America that drives so many into self-destruction? There are many possible explanations: economic dislocation, bleak job prospects, family breakdown, social isolation, the decline of religion and other sources of meaning. It won’t do to treat symptoms and ignore causes.

But neither will it do to put off immediate steps until we understand everything. A tragedy is raging every day. It demands our action.