A group of middle-aged whites in the U.S. is dying at a startling rate
washingtonpost.com
washingtonpost.com
It is very difficult, both emotionally and financially, to look back at a life of wrecked relationships and blown opportunities and not feel an intense disgust with yourself and a deep fear about the future.
Also, there is simply no place for you in society anymore. In your 50's, you are almost completely judged by your status in life; your house, your cars, your relationships...someone fighting addiction for 30 years will have little to none of this.
Even super close old friends eventually give up on you and stop returning calls.
I often say these days the only real regrets I have in life is hurting those who loved me due to my substance abuse lifestyle.
The hysterical "legalize everything" crowd has probably set back sane drug reform for decades. I don't think these people remotely understand how addiction ruins lives and families and how hard it is to get out of it.
The problem is the users and the traders are often lumped together (and sure there are users that trade too). Tackle the traders but leave the users alone. This will still drive up prices and will still force some people into crime (but other crimes than mere possession) but it would be a good first step towards treating substance abuse (and that includes alcohol by the way) as a personal problem rather than a crime.
That does not automatically translate into 'crack and heroin should be available at the corner store'. Nor does it translate into a free pass for traders or producers.
I prefer the Swedish model used to handle prostitution. Selling is legal, buying is the crime.
(Just to be clear, I don't actually like that model. I just find it interesting that it even exists when the general view for illegal transactions are that sellers are worse than buyers.)
Give me a break. Having the occasional beer is not substance abuse and shouldn't be criminalized.
Having the occasional beer should definitely not be criminalized and I'm the last person that would suggest so, in fact I think that no substance abuse should be criminalized as should be clear from reading the above comment.
I believe most dealers are users/addicts themselves now with our current policies, so going after the supply chain will only make this worse.
>and that includes alcohol by the way
We already tried making the production of alcohol illegal and it led to a lot of poisonings and blindness.
I think my approach is still superior. If we legalize the LEAST harmful of illegal recreation drugs, then there will be a harm reduction option for people who would otherwise do harder drugs. You can hunt down meth in the ghetto or go to the store and get high on pot. I imagine most will do the latter. The serious drug users in my life actually never got off drugs. They just got on safer drugs like pot.
The "legalize everything" crowd still makes no sense.
When you criminalize something, you push it underground and make it harder to treat; and when you do "treat" it, you do so with ineffective things like prison.
Except that "criminalize everything" makes it worse. By definition it creates crime (directly and indirectly), and the people who do need help are more likely to go to jail than to see a doctor.
However I can't imagine how much better off humans would have been if it never existed or was completely toxic to us.
Sometimes people like doing it because it lowers inhibitions and allows them to be more of their real selves. In that case they are bandaiding their own repression.
But mostly, it's because it's fun.
Anti drink was a social movement in the US for quite some time before it was law:
Not preaching as I am am far from a non drinker, it's just that as you get older you see more the nasty side and less of the fun side. Your hard partying pals from college have either transitioned into light drinkers or sad dependent stumbling cautionary tales.
For what it's worth, I'm more on the "decriminalize" side(ie, no jail time for simple possession, heavier fines/time for the sale/smuggling of significant quantities). Also, my own view may be biased from the fact that a parent was addicted to prescription opioids.
Just getting addicted is social harm and hard to recover from. Most addicts claims its a daily fight for the rest of their lives. I don't think millions (billions?) of dollars pushed into rehab programs are remotely as effective as trying to keep it out of the hands of would-be users.
Also, it makes more sense to address the mental issues addicts might be trying to self-medicate for instead of handing them a jug of meth and telling them to go have a good time.
>quite some time is prescription drugs
I imagine as we continue crack down on bullshit "pain clinics" this stuff is going to go way down. We're already seeing it Florida and elsewhere as legislation is catching up to corrupt doctors. I don't know why people make this sounds like its a given and will never change. The recent rise of prescription opiate abuse is well know and is being reigned back in.
Considering the effectiveness of prohibition is a rounding error away from 0, it wouldn't take much for rehabilitation to be better.
By that analogy, does that mean that you want to throw children in jail for using matches?
But we're remarkably okay with doing this for people who have ADD/ADHD.
This is an awful analogy unless you're looking to prove my point.
You can't possibly outlaw matches- they have too many common-good uses, and regulating their use and trade would be impossible even if you somehow made the first person guaranteed to be qualified to have one.
Prescription drugs are exactly the same way- and furthermore, short of actually inspecting every inch of every person/vehicle that comes in the country(and keeping vigilant watch of everything else), there's no way to seriously crack down on it(which btw, this entirely violates America's constitution, and I bet several other countries would have similar problems).
And even then, it wouldn't work, because how do we keep someone from giving it to a family member, or a friend? And how do we keep them from giving it to someone else? After all, even if the pain clinics are gone, that doesn't mean the abuse isn't happening. In my parent's case, they didn't go to a pain clinic- they had a dedicated physician prescribing it, one they had seen for years beforehand.
So we've got something that so far hasn't worked to the tune of billions and billions of dollars, would cost exponentially more money to do significantly better while also eroding basic human rights, then finally still won't completely solve the problem.
Or we just spend less money, not completely screw up the very concept of human rights, and clean up the mess leftover from the fact that people are human.
---
And hell, this is all assuming we even know of every drug that'll ever be created, which is obviously not true. So what happens when the next "crushing cold medication together in a bowl to get high" happens? Somehow do a check on all of those things, or simply let them go to the already set-up facility that exists to handle said problem?
From what I can see, people who want to keep drugs illegal believe that behavior always moves in the direction of the law. Nobody is naive enough to believe that outlawing something will stop it completely, but a lot of people believe that outlawing something reduces its incidence. That seems to be the approach taken by drug prohibitionists, and looks like it's your approach as well. It boils down to, X is bad, so we want to reduce the incidence of X, so let's outlaw X.
The problem is that outlawing something doesn't always reduce it. The experience of countries like Portugal is that loosening drug prohibition reduces drug addiction.
If addicts were provided with what they need a whole slew of society driven live ruining will go away.
If you step away from all the moralising you'll realise its better to simply pay addicts off. Society won't crumble because of it, in fact a lot of the problems will go away. A minority of the at 10-15% of people with addictive personalities will find a way to get high and you can nothing about that.
Addiction is a medical problem and should be treated like it.
Much of the country is not that way. My father in law is that age, and I think very few people in his community would judge him by that standard. He's a prominent member of a popular foodie Facebook group in his town, to the point where people stop him in the street and take selfies with him. In his community, that's a much bigger deal than owning a Porsche.
Almost all of my wife's side of the family (from coastal Oregon) is like that. Most of her cousins are doing great things with food, art, or in the church, and people praise them for that. When they ask what we do (we're both corporate attorneys), they nod politely. I am sure they would be horrified--rather than impressed--to hear how much we spend on rent.
You are kinda making my point for me, aren't you?
Notice I included the "your relationships" constraint.
I've yet to experience the "Hey, you were all messed up heroin a few years ago weren't you? Let's selfie..."
Obviously, AA/NA, volunteering, and perhaps even church groups are all potential ways to build social connections after a lifelong struggle with addiction.
But please, don't minimize too much how one's destroyed self-image affects one's motivation to begin anew, esp. in your 50's.
Stay well.
I lost a friend suicide and what perplexes me is why to do depressed people gravitate towards depressants like alcohol and Vicodin?
And they have helped me a lot. On a day-to-day basis I feel better than I did at 25.
Nonetheless I must be constantly vigilant lest my depression and alcoholism return.
I really feel for people who don't have the money for those things. If I ever became super-wealthy I would focus my philanthropy on mental health. If your brain is working at suboptimal level, it's really difficult to improve your life situation.
* Therapy off and on for about 20 years. I got something from all of it but the last five years in particular has been great. Currently I only go a few times a year, but for about a year I went once a week. $135 per session.
* Various prescription drugs, the most impactful of which has been Zoloft. Bit also Chantix to quite tobacco and Antabuse to help me with alcoholism
* Membership in mastermind groups - some business-oriented, others geared toward personal development. Usually there is at least one meetup/retreat involved. In 2013-15 I did one retreat per quarter. That group cost me about $10,000 a year in dues plus travel.
* Fitness classes - $150/month for the last five years or so
* Quality of life stuff like owning a luxury car, living in a beautiful place, international travel at least once a year, and so on.
How did Zoloft have such a great impact on you? Can you describe what you felt like off of it vs on it and how it changes you in a positive way? I'm very curious (and curious to know if it would benefit me long term).
It makes a huge difference. My mind doesn't wander into dark places as much, and when it does I'm able to redirect my thoughts somewhere else.
Also, with Zoloft I don't feel like I'm "on" something. I just feel normal.
The downside is it pretty much makes orgasm impossible, though I can temporarily get that back if I go off it for a couple days. This year I resolved to stay on it for all of 2015, because in the past I would often do it for 7-8 months, think "I feel great!" and wean myself off. I'll re-evaluate next spring.
Also, some supplements I take make a significant difference in energy levels. I was diagnosed with adrenal fatigue around the same time I started Zoloft. I did a saliva test and it turns out my cortisol is very low in the morning, making it hard to get out of bed and get going. The biggest impacts there seem to be from Rhodiola Rosea and DHEA, but I also take fish oil, B vitamins (see below) and a couple other things.
I also got a genetic test and found that I have the [heterozygous MTHFR mutation[(http://doccarnahan.blogspot.com/2013/05/mthfr-gene-mutation-...), and I take Deplin for that, though I believe non-prescription forms are available. That also seems to help with energy levels.
And I also do an annual-ish [SpectraCell](http://www.spectracell.com/) test through a local practitioner. From that we discovered that my B vitamins and testosterone were low (I'm in my late 40s so the testosterone change is not a surprise). I actually just completed another test and will get the results next week.
Finally, in the last three weeks I cut out all sugar and simple carbs. I've done that in the past but allowed a weekly "cheat day" that inevitably led me to fall off the wagon. This time I am very strict and I feel as energetic as I ever have in my life.
I don't thing cutting out sugar all by itself is the answer. Rather it's a combination of all these things that helps me develop the discipline and willpower around diet and exercise. Cutting out sugar does seem to prevent afternoon fatigue and general mood swings.
Others are not as cruel as you imagine them to be. You are the one holding yourself to this unkind standard. Yes there are some who are happy to join you in this belief, but that does not make it any less harmful or less your own choice.
There is no inherent command to look for reasons to continue to feel that you are not worthwhile. There are other things to discover that are equally as convincing if you give them a look.
When you become addicted to a substance, it's like it becomes revealed to society that you're a weak person. Like weakness is part of your identity. A good person is strong, a good person has the strength of will to not abuse substances. You're not a good person.
When you look back at your life, you see the same faults and have the same regrets. You think of yourself as a weak person.
The problem with those sorts of ideas is they reinforce the behavior that leads to things like substance abuse. They isolate you, they make you lose motivation, they make you act in a self destructive manner because you think you are the kind of person who should.
These are cultural elements that are present everywhere but relatively stronger in American culture. It really likes to put people into boxes, quite literally. People who commit a crime are considered criminals. The crime can be pretty minor, but maybe it sends you to jail. Criminals are bad, and people who go to jail are bad. Good people won't interact with bad people. You can lose your job, you can lose the ability to find another, you can lose your home, you can lose your ability to find another. But good people don't care, bad people go to jail. Bad people need to be punished. Bad people don't deserve our attention. Bad people don't deserve our money.
Other cultures are a bit less polarized. The need to brand someone good or bad isn't as strong. If you commit a crime, you go to jail, but you're treated like a person, you're given opportunities to correct some of the issues that sent you there, you're released in a manner that tries to help integrate you into the rest of society. American culture sees things like this and gets very angry. How dare you spend MY tax dollars on feeding THOSE bad people nice food, and give them comfortable beds!? How dare you help bad people fix their problems when good people fix their problems themselves?
A person who abuses substances needs to be helped. It's a problem that is self-reinforcing and really need some external support to break. The issue is that to ask for help identifies you as weak. It lets out the "secret" that you're not good enough, you don't have that imaginary "indomitable will" that good people have that keep them from doing bad things. The person feels this and is afraid to ask, and society feels this and will punish you for doing so.
It's like how mental health issues, like suicide attempts can go into your police file and keep you from being allowed to cross the border. These sorts of cultural impacts cause people to be afraid to look for help, and not just be afraid, but be punished for looking for help.
I think for the person in that situation, there's very little you can do to change the rest of society. But I think you can change your own mind, and I don't mean you can buck up and use that indomitable will to shrug off your addiction. I mean, you can recognize that you aren't a bad person or a weak person. You're not significantly different than your neighbor, it's just that you had a different set of circumstances 30-40 years ago and ended up learning a different set of habits and coping behavior. Had they been exposed to the same things and presented the same circumstances, they could be in your shoes.
You can identify the small things in life that are important, and you can look towards what is needed to make your life a bit more like that. It doesn't even have to be getting rid of your addiction, it could be that you want to keep your home tidy, it could be that you want to eat breakfast in the morning, it could be that you want to get in shape, it could be that you like to read Stephen King novels, it could be that you want to spend time with a friend. And you can do little things to move that forward. You can throw a couple of things off the counter into the garbage, you can get a dozen eggs for breakfast tomorrow, you could take a walk around the block, you could read a chapter, you could chat with a friend for a few minutes.
It's a matter of not believing the lie that you're any better or worse. You're a person who does some things. You've done some hurtful things, but at this point you can only do things now. You aren't a bad person, you aren't a good person. You're a person who can do things. And while society can limit their interactions with you because of their own mindset, you still have a lot of latitude to do many things despite that.
You're judged by your lifestyle. Yeah, that's unfortunate. But you can still clean your house, get up early and go for a run, eat some breakfast, read your favorite books and chat with your friends after work. The unfortunate part is that even if you "get your life back together" people's mindset might never change and think about the fact that people aren't strictly good or bad. It's more likely they'll just think you've changed and now you're good.
But maybe you will have learned that, and that's something.
It might not be too late to apologise to some of those you feel suffered, if they're still around.
Good luck for the future, and remember that those who know you now are lucky in every way :)
Now, back to the contemporary statistics: the correlation between increased mortality and socioeconomic groups 'hardest-hit' by recent economic concerns (globalization, the recession, and income inequality) seems quite clear, but I'm wondering if the correlation with mortality associated with drug poisoning would hold true if the same information were collected about a country with a less dysfunctional approach to narcotics and addiction management. I have a hunch that it wouldn't.
Yet in our own country, suicide is treated as a "mental illness", and rarely does anyone acknowledge the circumstances which make suicide the rational option.
One can argue that oppression and malaise are driving people to despair. It's another argument entirely to say that wasting a life makes sense.
I also knew someone who suffered great pain on a daily basis, and I have a hard time considering his suicide irrational. I knew a guy (a friend of a friend) who, through foolishness in his youth, ruptured three of his spinal discs, and had damaged two other ones. He was in constant excruciating pain. In the trailing decade of his life, he could not get sufficient pain relief to hold a job, could not get/afford treatment because of that, and basically was in a pain-filled hell, as he put it. At some point, after he'd been in near-constant excruciating pain for twenty years, he decided he no longer wanted to live.
I don't think either of these men were mentally ill, or making irrational choices.
There was a great article posted here on HN a while back by a number of highly-regarded psychologists that stated most suicides in men (who make up most suicides in raw numbers) are not actually due to mental illness at all, but rather cultural and philosophical factors combine with certain events in their lives leading to a sense of irreconcilable failure.
Hell, seppuku is a form of ritual suicide that has nothing at all to do with mental illness but it arrived at by a set of personal and moral values.
I'll see if I can dig the article up.
No man is an island, even if he feels like one sometimes.
Keep in mind that I'm making an ethical and moral argument. To a large degree, whether suicide should be legal is another discussion. To say someone shouldn't commit suicide isn't the same thing as saying it should be a crime to commit suicide.
That's not a place I want to be.
Sure, my preference is immortality of some kind, but at some point choosing non existence seems reasonable. IMO, as soon as you decide everyone get's the right to get off the ride at some point then I think you must also leave that choice up to them.
Can a terminally ill child choose to die? What if they have a significant life long illness that isn't terminal?
What if they have no illness?
Not saying it is impossible to work out all of these problems, I've just never seen anyone do so.
While in certain 'lifeboat scenarios' that brutal calculus must be undertaken, in general I am uncomfortable telling a class of people the should want to die and another class they should not.
In my mind, the people who chose to jump out of windows of the Twin Towers, instead of being engulfed by rapidly encroaching flames, made the only rational choice available at the time.
This stopped me in my tracks. Still not sure what I would have done but I would think I would try to find a way down. Now if I knew there was no way out...
To engage and promote mental health, it is better to try and see where people are coming from. Admitting that it is a rational option is not necessarily an endorsement. If you think it is, you need to reevaluate why you believe that all things rational are identical with all things good.
This isn't just a US problem, though it may be worse there in some ways. There's also the problem that "mental health" is not well understood scientifically, yet the medical community acts as though it were. You can thumb through the DSM V and find countless seemingly well-defined "diseases" described using the language of science, yet for few is any underlying cause known and very often the "symptoms" are vague and useless for differential diagnosis. Ultimately all of this is defined by a group of people who have a particular agenda that does not necessarily serve the rights and best interests of the individual being diagnosed as potentially "ill".
That does not mean there is no such thing as a disease of the brain or body that affects behavior, only that anyone who tells you they know what behavior is a sign of disease and what is not, or of which disease it is a sign, or the cause of that disease, much less a proper course of treatment, is usually at best guessing and at worst lying. The psychology and psychiatry communities are roughly where the rest of medicine was in the early 19th century: deeply paternalistic researchers with impressive titles and great big books full of fancy language that amounts to little more than guesswork and superstition, who are nonetheless at least trying to pursue difficult knowledge in what they best understand to be a scientific manner, and a much larger body of clinical practitioners who are for the most part little better than self-serving quacks.
Until that changes in deep and fundamental ways, I'm not ready to condemn anyone to forced treatment, nor to criticize any self-treatment short of criminal injury to others. Medicine couldn't save you from TB in the 19th century (too often, it still cannot), and it may well be that neither can it save you from addiction or myriad other brain diseases today. The solution to that was and is the scientific pursuit of knowledge for the future, not the mockery or damnation of those who decline the usually ineffective (or "heroic", or otherwise horrifying) treatments on offer at the time.
> To engage and promote mental health, it is better to try and see where people are coming from. Admitting that it is a rational option is not necessarily an endorsement. If you think it is, you need to reevaluate why you believe that all things rational are identical with all things good.
Very true. Moreover, people are far too quick to criticize others' decisions as irrational when the other person's value system differs from the critic's. Very often the choices being made are rational in the context of the subject's value system, but the critic cannot or will not understand or accept that the subject does not share his or her values (or indeed that multiple value systems are possible), and so criticizes their choices under their own and concludes that they are irrational. A declaration that someone is irrational says a great deal about the critic but rarely anything much about the subject. Getting past this block is perhaps the most important aspect of useful empathy.
Someone else commented that our culture is broken - I agreed.
To say nothing of the political nature of declaring something as being a disorder or not. Read about the decision to remove homosexuality back in the DSM-III and the decision to remove pedophilia in the DSM-V and realize how highly political these moves were (many professionals aren't even aware of that change in the DSM-V and unless you pay close attention, a reader could easily miss the differences between pedophilia in the DSM-IV-TR and pedophilic disorder in the DSM-V).
One may as well dismiss diagnosis of plague during the Black Death because germ theory had not been discovered yet.
That's fairly common in medicine even outside of psychiatry: typically, a set of related symptoms are identified and named, then later -- often many years later -- mechanisms that appear to occur with and likely generate the symptoms are identified and then later -- often many years later again -- root causes are identified for what causes those mechanism to begin operating.
And quite a lot of non-psychiatric medicine is at the first or second stage (and even lots that gets portrayed as being at the third stage sees frequent revisions to the ideas of the "root causes", so its only really at the second stage with efforts being made at the third stage.)
The idea that the absence of knowledge of root causes is something that distinguishes psychiatric medicine from the rest of medicine is only possible in complete ignorance of the rest of medicine, even if it is very commonly the basis of politically motivated rants against psychiatry on the internet.
Sure, that's still useful. But then it should be used as a catalogue for further study, not a diagnostic tool and certainly not the basis for prescribing treatments that often do more harm than good. And above all, by no means is such an incomplete catalogue appropriate basis for forcibly detaining someone or otherwise dictating what they must or must not do.
Other physicians have, slowly and with difficulty, come to terms with the limits of their knowledge and sometimes even how to communicate those limits to patients. When diagnosis is uncertain or the effectiveness and side effects of treatments poorly understood, advice is (among the better physicians) tempered by an honest effort to convey the risks and benefits given the unknowns. If nothing else, the guidance of Hippocrates still prevails. I don't see that from psychologists or psychiatrists, and the DSM and its current uses form a perfect case study in their hubris. When in doubt, diagnose; when in doubt, treat, whether the patient wishes to be treated or not, with whatever is handy regardless of whether there is any basis to expect it to work. Again, all traits of pre-modern medicine.
If you think I'm being too hard on these disciplines, consider that medicine as a whole -- while I acknowledge its many faults and would not pretend that its understanding or attitudes are anything resembling perfect or complete -- has at least in principle advanced beyond these particular errors. That should offer hope that someday psychology and psychiatry will advance similarly.
The vast majority of suicides don't qualify, but we shouldn't say it's always irrational any more than we should say it's always rational.
For the rest of the cases I think of suicide as the ultimate result of mental illness. When someone with cancer dies, we say cancer killed them.
When someone dies of suicide, for most cases it was mental illness that killed them.
Because suicide is mostly a symptom of mental ill health - although sometimes the person isn't in contact with services and doesn't have a diagnosis.
Wealth inequality has been rising for a very long time, with all but the highest income brackets stagnating. This isn't sustainable, it's literally causing the serfs to be so stressed that they die or kill themselves because of how few resources they get. We need at least some of these people alive and functioning if our society is to continue.
- 62.4% Civilian Labor Force Participation Rate - the lowest in 38 years! (http://data.bls.gov/timeseries/LNS11300000)
- 9M people on Disability Insurance, double the number in 1995 and six times the number in 1970 (http://fortune.com/2015/10/08/disability-insurance-unemploym...)
I see despairing articles about the state of the American middle class in the media all the time.
In fact, this very article is from the mainstream media.
You can't really have it both ways. We can't have automation, competitiveness, efficiency, a move way from the consumerist lifestyle, etc and expect 1970's style employment levels. Not to mention, at lot of the jobs from that era were back-breaking and dangerous manufacturing jobs. These weren't desirable jobs and many of the people who had them did their best to work their way out of them via retraining, college, moving to management, etc.
Keeping everyone employed is just a fool's errand this late in the capitalism game. More "make work" jobs isn't the solution here. Ideally, this is the narrative we need to start spreading. Things like minimum guaranteed income shouldn't be shameful concepts to push.
The American work ethic is to compete viciously for chances to work hard, for too long, forever, for little in return. It's an unmitigated failure, but people fear change and cling to tradition.
It is failing because greed has become the norm. People's attitudes have gone from help your family and friends to help yourself. It has moved away from community to individualism. That's what's changed.
When Andrew decimated south Florida people were in dire straights. Everyone wanted to help. When the convoys of utility workers, food and water were allowed to go in finally, people pulled off the side of the highway and cheered and wept because, finally, help was on its way.
Contrast that to the bumbling eff up that was Katrina. People were falling over themselves trying to blame everyone else for that.
That's the difference now. How we got this way, I don't know. But it's disgusting.
A basic income doesn't fix this. We need an attitude adjustment in this country.
Lack of trust and loyalty is a self-reinforcing pattern that must be broken by someone taking the first step, knowing that they might get burned.
Many executives are incentivized to maximize short-term "results" at the cost of long term strategy. Once the reality bites (stock is falling, due to lower revenues, due to outdated products), they quickly come up with a "turnaround plan". The stress is on "quickly", so there is no time to re-train existing workforce, which is fired and new people with required skills come in (at a huge price of recruiting costs, ramp-up time, etc).
Executive compensation should not be tied so much to the stock price, as it leads to pump-and-dump tactics, killing companies in the long term and doing a lot of harm to employer-employee relations as well.
I thought the United States was all about rugged individualism and self-interest? Either way, individualism is not the problem, and has always been a staple of American life. Nor is it "greed" (which has always been present), unless you also define spontaneous order brought by catallaxy to be a form of greed.
The issue is the Protestant work ethic has always been nothing but a feel-good tale that is obviously and demonstrably a plain falsehood, or at best an oversimplification. Of course, it's a part of cultural identity and gives people the fuzzies, so it remains believed due to the illusion of control it brings. Also because people are inclined into thinking in terms of the just-world fallacy, again so as to maintain illusion of control and teleological certainty.
I suspect large numbers of American lives are being shortened, even if not by outright suicide, through diseases caused by constant stress, mostly economic.
People feel that things were better 10 years ago. They were still getting squeezed then, too, but it wasn't nearly as bad as today. I predict that suicide/mental illness rates for people entering their 30s are quite poor right now as well, given the student loan burden and lack of traction regarding jobs or wealth generation.
It isn't wealth inequality or the existence of "insanely rich" per se, it's the ever-growing sector of Americans who are excluded from wealth and who no longer see any realistic hope of changing that through their own efforts. It's the latter view that is a growing suicide motivator, IMHO.
There is some indication that certain forms of non-chronic adrenaline producing stress (even life threatening ... ie sky diving) may help prevent depression (I'll find a reference shortly).
I honestly believe that increased opioid usage is playing a huge part here and not wealth (at least through my own observations). In fact wealth and health care availability might actually be stimulating opioid usage (ie getting pills from doctors).
Rather, it's stagnating wages and declining economic outlooks which are negatively impacting the 99%.
It's important to separate these things, because the landscape of policy solutions are dramatically different.
A graph in the article [0] shows a large spike in deaths by poisoning, a modest increase in suicides and chronic liver disease, no change in diabetes, and a decrease in lung cancer. So the authors quasi-conclude that the increase in this demographic is due to underlying psychic pain (tough times post-recession?) that causes people to overdose/die from alcohol poisoning.
There is a weird stat at the bottom of the article - according to the "National Heroin Task Force" (who knew there was such a thing) 110 people overdose on legal/illegal drugs every day. The CDC says that only 6 people die from alcohol poisoning every day. So if we take those stats at face value, which we probably shouldn't because the National Heroin Task Force has an incentive to overblow the problem, then we would conclude that heroin is a much larger problem than alcoholism across this demographic.
One other discrepancy was the author throwing in this strange citation that (supposedly) bemoans the future of Medicare:
"This is the first indicator that the plane has crashed," said Jonathan Skinner, a professor of economics at Dartmouth College, who reviewed the study and co-authored a commentary that appears with it. "I don’t know what’s going on, but the plane has definitely crashed."
It's not often that you see this level of insightful journalism and deep analysis, so I took a moment to savor that nugget of knowledge. Then I wondered - isn't it a "good" thing for the Medicare system if the working class is dying off after contributing to the pot but before taking anything out?
[0] https://img.washingtonpost.com/rf/image_1484w/2010-2019/Wash...
So as painkiller overdoses leveled off at about 16,000 in recent years, heroin deaths skyrocketed from just over 3,000 in 2010 to more than 8,200 in 2013, according to CDC data. Though all heroin users didn't necessarily start with painkillers, it's the transition from painkillers to heroin, Humphreys and other experts say, that led to the recent dramatic spike in heroin abuse.
Below is a link to a Vox article that presents evidence regarding the above quote, and the reason there's a heroin epidemic in the US is because of the overly aggressive (lobbied, and punished for dishonesty in marketing) pharmaceutical industry pushing opiate drugs. Now, with the crackdown on pills, there are wide, wide swaths of the US population who've gone from pills to the horse:
http://www.vox.com/2015/10/1/9433099/opioid-painkiller-heroi...
Cartel De Golfo, more in the cocaine trade. The former Knights Templar in Michochan, methamphetamine production (in part due to dealing with the Chinese - illegal mining in trade for access to precursors). Quite a fascinating development from what I've seen. Where there's profit to be made...
So alcohol causes 10x the amount of deaths per year, and when you factor in economic damages caused by people operating machinery, driving, hurting themselves when drunk it seems like heroin abuse is neither a "much more fatal problem" nor a much more widespread problem than alcoholism. Faster growing, yes.
In 2013, 86.8 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime; 70.7 percent reported that they drank in the past year; 56.4 percent reported that they drank in the past month... In 2013, 24.6 percent of people ages 18 or older reported that they engaged in binge drinking in the past month
...and, via the 2010 US Census, there are 193,000,000 people between the ages of 18 and 64.
So, if we consider the math, many, many more people consume alcohol than heroin, and as such, 88,000 is a much smaller "fatal problem" than you frame it. So, not as widespread as alcoholism, but much more fatal for those affected. I stand by my assertion that there's no need to "over-state" the heroin problem in the US.
It is a bad time for those that are not academically gifted.
See: unemployment rate among Americans with a four year degree, or any college experience at all for that matter. The unemployment rate is hyper low.
That unemployment rate is half that of the European Union, as is the unemployment rate across the board in the US.
More people in the US are moving up from middle skill jobs to higher skill, better paying jobs, than are falling from middle skill to lower skill jobs:
http://i.imgur.com/WLJ73C7.png
If you want to talk about crushing debt, see: Canada, Australia, UK, Japan, Sweden, Norway, Finland, Denmark, Netherlands - all of which have worse household debt to income levels than the US (including the student debt in the equation). Canada's household debt to income ratio, as one example, is now nearly twice that of the US. Denmark's is three times that of the US; Norway's is over twice that of the US.
The US also has a lower share of adults still living with their parents compared to most of Europe. In some cases, dramatically lower (Portugal is 44% vs 14% for the US).
The US has one of the highest median incomes, and median disposable incomes. Higher than: Germany, UK, France, Spain, Italy, etc.
The US has a higher median net household wealth level than Germany or Sweden.
The US median student debt among people with any student debt, is $13,000. Household debt to income levels have been falling for six straight years, and are back to normalized levels last seen during the boom days of the 1990s.
What you're claiming, doesn't hold up under any scrutiny.
College is expensive, and it's bad, but private schools are an order of magnitude more expensive; the popular narrative typically ignores public schools which cost roughly 50-80K for an undergraduate degree, depending on location. Private schools run around 200K+ at full cost, I believe.
I personally sucked up a fairly large of debt because I made several poor choices. This is not the case, in general, for my peers, who chose better.
Is this just reversion to the mean? That is, is the death rate for working-class white people simply converging to to the death rate for African Americans?
If so, that's the most horrible way to end white privilege :(
It likely includes the large increase in pill overdoses by that white demographic since the mid to late 1990s. It's something that whites in the US seem to abuse more than any other group of people in any other country. Doctors in the US have become drug addiction facilitators.
Further, historically American whites had among the highest life expectancy, between 1800-1970 - right until the obesity explosion left Americans trailing behind. So what reversion to the mean? Reversion would be that American whites drop the obesity, go back to 1970 weight levels, and live five years longer.
It may be the impact to others that gave smoking it's stigma compared to alcohol. Smoke drifts through the air and leaves a pungent smell in clothing. For non-smokers, this can be far more impacting than alcohol when both substances are consumed in moderation.
Imagine the first Europeans to encounter it. "What is this?" "Tobacco, sir" "What do you do with it?" "Why, roll it up, stick it in your face, and light it on fire"
If this is supposed to be sarcasm, I'm missing it.
We started the millennium with a stock market crash, 9/11, the Concord crashed, the Space Shuttle broke up on reentry, two wars kicked off and just when things started calming down... the Great Recession. If you weren't laid off then you probably knew a few people that were. It seemed like everything we had built over the past two decades was failing us all at once.
The 90's seemed like a time when you just watched Seinfeld on Thursday nights and watched your stocks go up in value. The 2000's and on have been a bit more stressful.
The abstract for the paper says This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis.
( http://www.pnas.org/content/early/2015/10/29/1518393112.abst... )
So strokes probably don't explain it.
In a previous discussion I speculated that military service (and thus combat) could be a contributing factor. It would be interesting to see how many of the suicides and overdoses were people who had experienced combat.
The article details the increasing causes of mortality in this group.
Can you talk about this more? Some family members have routine complaints of chronic pain without a concrete physiological root cause, and I'd like to understand your comment further.
http://cbsnews1.cbsistatic.com/hub/i/2014/07/01/98ca03d6-2e2...
Source:
http://www.cbsnews.com/news/the-states-with-the-worst-prescr...
The US has an obesity epidemic right now and it has huge risks for some of these health issues:
1. high blood pressure
2. diabetes
3. heart disease
4. cancer
5. ulcers
Yet absolutely no mention of this in any of the stats or the issues which may be contributing to early deaths of this segment of the population.
"...the study clearly shows they are not the result of diseases such as lung cancer or diabetes, which are declining and increasing slowly, respectively."
That is, the paper would mention it if the population in question had seen an unusual rise in deaths from cardiovascular diseases and cancers.
Especially divorce.
However % of out-of-wedlock births have continued to rise.
Anecdotally and statistically, it seems like 'Family Court' findings are the major cause for a precarious-to-struggling decade long stretch of life.
The generation of "middle-aged whites" (which the article describes as being aged 45-54 between 1999 and 2013) probably doesn't get enough credit. So... lack of college education is a common denominator in many of their deaths. But people keep forgetting the information economy came after we had our hefty physical infrastructure.
Alcohol and drug abuse are how people self-medicate when they can't afford expensive / professional medical care. We're only barely starting to scratch the surface of this problem with AHA; but for many of the "uneducated" people in this generation who were/are employed in construction / physical labor... it probably seems like too little too late.
This basically sums up my fears. Whatever is going on, economics is at the root of it.
What did this group's wages do during this same time period? Something had to push them to this. I am guessing this is it.
The idea was great, but further studies failed to reproduce the original results and all major science journals rejected the paper.
We are not making it easier to handle this big issue of addiction by relying on fals or unreproducible data.
Kudos to the authors and journal for providing a full PDF immediately. Boo to the Washington Post for not linking.
I guess the propaganda has worked.