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Alcoholism. Drug overdoses. Suicide.
These "deaths of despair" could reach 150,000 in the U.S. if more isn't done to provide access to mental health care, increase emotional well-being, mitigate social isolation and blunt the impact of an economic downturn that has wiped away at least 40 million jobs, researchers warn.
"More Americans could lose their lives to deaths of despair, deaths due to drug, alcohol, and suicide, if we do not do something immediately," the executive summary of the study released in May by Well Being Trust states. "Deaths of despair have been on the rise for the last decade, and in the context of COVID-19, deaths of despair should be seen as the epidemic within the pandemic."
According to the U.S. Department of Health and Human Services' National Survey on Drug Use and Health, there were 57.8 million Americans living with mental and/or substance use disorder in 2018, a number that doesn't reflect the impact of the coronavirus pandemic.
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A new study estimates how much so-called "deaths of despair" could increase amid the COVID-19 pandemic. The above illustration shows areas of the brain involved in the process of depression. (Photo by: BSIP/Universal Images Group via Getty Images)
“Currently, suicide is the 10th-leading cause of death in our nation,” said Elinore F. McCance-Katz, the HHS assistant secretary for Mental Health and Substance Use, in a statement. “We know the stressors that are accompanying this pandemic – job loss and financial instability, anxiety, grief, depression and other factors – can lead to suicide and suicide attempts.”
The Substance Abuse and Mental Health Services Administration announced on May 13 a $40 million grant program for suicide prevention efforts as part of the government's response to the pandemic.
The Well Being Trust study estimates anywhere from 27,644 to 154,037 additional deaths of despair in the U.S., depending on how quickly the economy recovers. However, the study's authors note that their projections are based on data from the 2008 Great Recession – many economists believe this downturn is much worse – and don't take into account developments in telemedicine and other forms of digital social connection. Therefore, the study's numbers should be seen as estimates and not foregone conclusions.
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Due to social distancing measures that have slowed the spread of the virus, many health care programs and well-being services aren't as accessible.
"Many of the hospitals with dedicated beds for client detox had to reassign them to treat the influx of COVID-19 or critical patients, which limits the available treatment for those clients in acute withdrawal," said Ellery Tarife, a certified nurse practitioner who oversees the outpatient withdrawal management program at CarePlus NJ. "Many private substance use disorder treatment facilities have limited their capacity and decreased their admissions, while some have even closed their doors for the time being."
CarePlus NJ, a nonprofit organization that offers a range of mental health care, substance abuse prevention and recovery-focused primary care services, is still providing therapeutic services – either virtually or in-person – during the pandemic. For people who are struggling in more extreme ways, Tarife may see them in weekly sessions, and clients can still come into the office for face-to-face visits if they need them.
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"In addition to the social isolation, skyrocketing unemployment rates and the fear and uncertainty surrounding the virus can serve as triggers to continued or increased substance use," explained Tarife. "Clients can relapse, or increase their current usage while isolated, and without the appropriate checks and balances associated with treatment and support groups, things can escalate."
CarePlus’ Addiction Recovery Services program takes what it calls a "holistic approach" to addiction treatment by offering a wide range of outpatient services, as well as psychiatric evaluations, support groups and therapy, based on the needs of each person.
As of Monday afternoon, there were almost 1.8 million infections and at least 104,584 deaths in the U.S. from COVID-19.