Issue Category: Substance Misuse and Mental Health
U.S. Death Rate Due to Alcohol, Drugs, and Suicide Increased by 11 Percent in 2021
Increases occurred among all ages, races, and geographic groups, but were particularly high for youth suicides and overdoses among certain populations of color
(Washington, DC – May 24, 2023) – The rate of U.S. deaths due to alcohol, drugs, and suicide climbed 11 percent in 2021, according to Pain in the Nation 2023: The Epidemics of Alcohol, Drug, and Suicide Deaths, a new report released today by Trust for America’s Health (TFAH).
While an all-time record, 209,225 Americans lost their lives due to alcohol, drugs or suicide last year these deaths are part of a two-decade trend of sharply increasing fatalities due to substance misuse and suicide in the U.S. The 2021 data showed such deaths were up across the U.S. population, with the largest increases occurring among certain populations of color as well as people living in the South, West, and rural regions of the country.
- Drug overdose deaths increased by 14 percent between 2020 and 2021, with larger increases among Native Hawaiians and Pacific Islanders, American Indian/Alaska Native people, and among youth and older adults. For the year, drug overdose rates were highest among adults ages 35 to 54, males, Black people, and young adults ages 18 to 34.
- Alcohol-induced deaths increased by 10 percent between 2020 and 2021, with the highest increases among Native Hawaiians and Pacific Islanders, Latino people, and American Indian/Alaska Native people.
- Suicide mortality increased by 4 percent between 2020 and 2021, with the highest increases among American Indian/Alaska Native people and Black people.
While the 2021 trends were not good news, they were an improvement over the 2020 data. For 2020, the number of alcohol, drug, and suicide deaths was up 20 percent as compared with 2019.
“The data continue to show alarming increases in deaths due to substance misuse and suicide,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “What is needed is urgent and sustained investment in policies and programs that prevent the root causes of substance misuse and suicidality. We need to prevent adverse childhood experiences and trauma and support mental health services in schools, within healthcare settings, and in community settings for all populations.”
Two Decades Overview
Deaths due to alcohol, drugs, and suicide have been on the rise for over two decades, doubling over the period from 104,379 deaths in 2011 to 209,225 in 2021. Between 2016 and 2021, the escalation in the rate of drug overdose deaths was more than 60 percent. These increases disproportionately impacted Black and Latino populations.
Most of the upturn in deaths due to drug overdose involved opioid overdose, with additional deaths due to cocaine and psychostimulants. In addition, a new and growing threat is xylazine, a tranquilizer approved for veterinary use but mixed with fentanyl to create a highly toxic illicit drug combination.
During the last two decades alcohol and suicide deaths have also increased, but not as sharply as drug deaths.
Youth Suicide Risk
Over the last decade, alcohol, drug, and suicide deaths among youth ages 10 to 17 increased by 65 percent. While youth have a much lower suicide rate than the general population, the upward trend of youth suicide, beginning well before the COVID-19 pandemic—a 71 percent increase tween 2010 and 2021—is tragic and warrants immediate attention. Unlike for other age groups, an increase in suicide deaths among young people was the primary driver for the age group’s increased overall mortality.
American Indian/Alaska Native and LGBTQ youth are most at risk for poor mental health and suicidal behaviors.
Veteran Suicide Risk
Veteran suicide risk also needs immediate attention. The suicide mortality rate for veterans was 32 deaths per 100,000 veterans in 2020, a much higher rate than the general population.
Evidence-based Programs Can Help Reverse Deaths of Despair Trends
In response to the growing deaths of despair crisis, a multifaceted approach to improving mental health and well-being in every community is needed. The report includes recommendations for steps federal, state, and local government and other stakeholders should take to address substance misuse and suicide deaths. The recommendations include:
- Invest in prevention programs and conditions that promote health including programs that prevent or reduce adverse childhood experiences and provide trauma-informed services, student mental health services in schools, and strengthened crisis intervention programs, including the 988 crisis lifeline.
- Prevent substance misuse and overdose by supporting syringe service programs, increasing naloxone and fentanyl test strips availability, and expanding funding for the Drug-Free Communities Support Program to bolster prevention programs for youth specifically.
- Transform the mental health and substance use prevention system by increasing access to mental health and substance use healthcare through full enforcement of the Mental Health Parity and Addiction Equity Act, integrating mental health and substance use treatment with other healthcare services, and expanding culturally and linguistically appropriate care for populations of color and other underserved populations.
Read the full report
Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.
COVID-19 and Drug Overdose Deaths Drive U.S. Life Expectancy Down
(Washington, DC – January 17, 2023) — Data released by the Centers for Disease Control and Prevention in December 2022 showed that U.S. life expectancy decreased from 77 years in 2020 to 76.4 years in 2021, the second consecutive year that U.S. life expectancy decreased. The last time the U.S. experienced a two-year decrease in life expectancy was during World War II.
Age-specific death rates from 2020 to 2021 increased for all age groups other than infants less than one year old. American Indian and Alaska Native females experienced the largest increase in death rates, jumping 7.3 percent in 2021. Lower life expectancy for some populations groups, disproportionately among people of color, have been attributed to the structural inequities and barriers to optimal health that those communities experience.
Heart disease remained the leading cause of death in the U.S. during 2021 followed by cancer and COVID-19. In addition, drug overdose accounted for over a third of all unintentional deaths. During 2021, 106,699 people died in the U.S. due to a drug overdose, a 14 percent increase in the overdose death rate over 2020.
“These data underscore the importance of TFAH’s work to advance public health, prevention, and health equity,” said TFAH President and CEO J. Nadine Gracia, MD, MSCE. “The COVID-19 pandemic has highlighted the impact of social and economic conditions on people’s health and a community’s ability to be resilient during an emergency. TFAH will remain steadfast in advocating for policies that promote optimal health and well-being for every person and community. Among our priorities are supporting policies and programs that will strengthen the nation’s public health workforce and data systems; investment in substance misuse and suicide prevention including school-based mental health services and primary prevention programs; increased investments in chronic disease prevention programs including obesity prevention; and addressing the social determinants of health.”
Learn more about the causes of declining U.S. life expectancy in this TFAH issue brief: U.S. Experienced Steepest Two-year Decline in Life Expectancy in a Century – TFAH
For more on TFAH’s recommendations to improve the nation’s emergency preparedness: Ready or Not 2022: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism – TFAH
For more on TFAH’s recommendations on needed investments in the nation’s public health system: The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2022 – TFAH
For more on TFAH’s recommendations on addressing the nation’s drug, alcohol and suicide crisis: Pain in the Nation 2022: U.S. Experienced Highest Ever Combined Rates of Deaths Due to Alcohol, Drugs, and Suicide During the First Year of the COVID-19 Pandemic – TFAH
For more on TFAH’s recommendations to address the nation’s obesity crisis: State of Obesity 2022: Better Policies for a Healthier America – TFAH
New CDC Data Shows 4 Percent Rise in Suicides in 2021
On September 30, the Centers for Disease Control and Prevention (CDC) released a new report on provisional data on suicide mortality in 2021. The new data shows a 4 percent increase in the national suicide rate—rising from 13.5 deaths per 100,000 population in 2020 to 14.0 deaths per 100,000 population in 2021. In contrast, the national suicide rate declined in both 2019 and 2020, though it had steadily increased over the previous two decades.
The report also includes additional information on suicide by sex, age group, and month. Key takeaways:
- Suicide rates increased more among males (3 percent increase) than females (2 percent increase).
- Suicide rates increased for people in nearly all age groups. The only exception was a 2 percent decline for people age 75 and over, though it was not a statistically significant change.
- The largest statistically significant increase among all sex/age groups was for males aged 15–24, with an 8 percent increase in suicide rate from 2020 to 2021. Females aged 10–14 had the largest percentage increase in suicide rate (15 percent), though the change was not statistically significant due to a relatively small numbers of cases.
- There were more suicides across all months of 2021 compared with 2020, except in January, February, and July. The largest increase across all the months was an 11 percent increase in suicide rate in October.
The report does not include racial/ethnic or geographic information, nor information on suicide method—all critical pieces to understanding the full picture. For example, data from 2020 showed higher rates of suicide among American Indian, Black, and Latino people and of suicide by firearm—all in a year when the overall suicide rate declined. The National Center for Health Statistics will likely release final 2021 mortality data, including these additional data points, in December.
“The increase in suicide is devastating,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health (TFAH). “The new data underscores the need for more attention on this issue and action to prevent future suicides—by federal policymakers, the private and non-profit sectors, and every community across the nation. This study is a wakeup call that we continue to face a mental health and substance use crisis, but we can prevent these tragic deaths.”
The most recent Pain in the Nation report from TFAH includes 2020 data and an analysis of longer-term trends, as well as policy recommendations for reducing alcohol, drug, and suicide deaths. The new CDC report reaffirms the importance of many of these recommendations, including to:
- Strengthen the continuum of crisis intervention programs with a focus on the newly established “988” lifeline.
- Expand CDC’s comprehensive suicide-prevention efforts, including measures to strengthen economic supports, promote connectedness, and create protective environments.
- Address the social determinants of health and promote resilience in children, families, and communities, including through economic supports, access to quality childcare, and prevention and early intervention efforts in schools.
- Build grassroots community capacity for early identification and intervention for individuals with mental health and substance use disorders, including through community-based or non-traditional settings.
- Limit access to lethal means of suicide, including drugs and firearms, among individuals at higher risk of suicide through state and federal laws, more funding of foundational research, and the adoption of counseling programs in healthcare systems.
New CDC Data Shows 4 Percent Rise in Suicides in 2021
On September 30, the Centers for Disease Control and Prevention (CDC) released a new report on provisional data on suicide mortality in 2021. The new data shows a 4 percent increase in the national suicide rate—rising from 13.5 deaths per 100,000 population in 2020 to 14.0 deaths per 100,000 population in 2021. In contrast, the national suicide rate declined in both 2019 and 2020, though it had steadily increased over the previous two decades.
The report also includes additional information on suicide by sex, age group, and month. Key takeaways:
- Suicide rates increased more among males (3 percent increase) than females (2 percent increase).
- Suicide rates increased for people in nearly all age groups. The only exception was a 2 percent decline for people age 75 and over, though it was not a statistically significant change.
- The largest statistically significant increase among all sex/age groups was for males aged 15–24, with an 8 percent increase in suicide rate from 2020 to 2021. Females aged 10–14 had the largest percentage increase in suicide rate (15 percent), though the change was not statistically significant due to a relatively small numbers of cases.
- There were more suicides across all months of 2021 compared with 2020, except in January, February, and July. The largest increase across all the months was an 11 percent increase in suicide rate in October.
The report does not include racial/ethnic or geographic information, nor information on suicide method—all critical pieces to understanding the full picture. For example, data from 2020 showed higher rates of suicide among American Indian, Black, and Latino people and of suicide by firearm—all in a year when the overall suicide rate declined. The National Center for Health Statistics will likely release final 2021 mortality data, including these additional data points, in December.
“The increase in suicide is devastating,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health (TFAH). “The new data underscores the need for more attention on this issue and action to prevent future suicides—by federal policymakers, the private and non-profit sectors, and every community across the nation. This study is a wakeup call that we continue to face a mental health and substance use crisis, but we can prevent these tragic deaths.”
The most recent Pain in the Nation report from TFAH includes 2020 data and an analysis of longer-term trends, as well as policy recommendations for reducing alcohol, drug, and suicide deaths. The new CDC report reaffirms the importance of many of these recommendations, including to:
- Strengthen the continuum of crisis intervention programs with a focus on the newly established “988” lifeline.
- Expand CDC’s comprehensive suicide-prevention efforts, including measures to strengthen economic supports, promote connectedness, and create protective environments.
- Address the social determinants of health and promote resilience in children, families, and communities, including through economic supports, access to quality childcare, and prevention and early intervention efforts in schools.
- Build grassroots community capacity for early identification and intervention for individuals with mental health and substance use disorders, including through community-based or non-traditional settings.
- Limit access to lethal means of suicide, including drugs and firearms, among individuals at higher risk of suicide through state and federal laws, more funding of foundational research, and the adoption of counseling programs in healthcare systems.
Letter in Support of the Improving Data Collection for ACEs Act (August 2022)
Pain in the Nation 2022: Congressional Briefing and Webinar
Deaths associated with alcohol, drugs, and suicide took the lives of 186,763 Americans in 2020, a 20 percent one year increase in the combined death rate and the highest number of substance misuse deaths ever recorded for a single year. These data are part of a report releasing today, Pain in the Nation: The Epidemics of Alcohol, Drug, and Suicide Deaths, the latest in a series of reports tracking the nation’s deaths of despair crisis produced by Trust of America’s Health and Well Being Trust.
No single program or policy will be a cure-all to address these issues. Instead, a comprehensive approach that focuses on the underlying causes of these deaths of despair can help heal individuals and communities and make them more resilient.
Resources:
Trust for America’s Health
- Pain in the Nation 2022 Policy Fact Sheet
- Pain in the Nation: The Epidemics of Alcohol, Drug, and Suicide Deaths
Well Being Trust
- A Nation in Pain,written by Dr. J. Nadine Gracia and Benjamin F. Miller
- A Small Light in a Vast Darkness, written by Benjamin F. Miller
- Evokate
- StrengthinUs
Pain in the Nation 2022: U.S. Experienced Highest Ever Combined Rates of Deaths Due to Alcohol, Drugs, and Suicide During the First Year of the COVID-19 Pandemic
Estados Unidos experimentó las tasas combinadas más altas de muertes debido al alcohol, las drogas y el suicidio durante la pandemia de COVID-19
Las muertes abarcaron edades, grupos raciales y étnicos y geografía, pero dañaron de manera desproporcionada a ciertos jóvenes y personas de color.
Las soluciones son conocidas y deben implementarse
(Washington, DC – 24 de mayo de 2022) – Las muertes asociadas con el alcohol, las drogas y el suicidio cobraron la vida de 186.763 estadounidenses en el 2020, un aumento del 20 % en un año en la tasa de mortalidad combinada y la mayor cantidad de muertes por uso indebido de sustancias jamás registrada durante un solo año, según un informe publicado hoy por Trust for America’s Health (TFAH) y Well Being Trust.
Además, los datos provisionales de los Centros para el Control y la Prevención de Enfermedades muestran que las muertes por sobredosis de drogas continuaron aumentando en el 2021.
Si bien las muertes por alcohol, drogas y suicidio han aumentado durante décadas, el aumento durante el 2020 no tuvo precedentes y fue impulsado por un aumento del 30 % en la tasa de muertes inducidas por drogas y un aumento del 27 % en la tasa de muertes inducidas por el alcohol. Las tasas combinadas de muertes por alcohol, drogas y suicidio aumentaron en los 50 estados excepto New Hampshire, y por primera vez dos estados (Virginia Occidental y Nuevo México) superaron las 100 muertes por cada 100,000 residentes estatales por alcohol, drogas y suicidio combinados en un solo año
o La tasa general de muertes inducidas por drogas aumentó en un 30 por ciento, en gran parte impulsada por aumentos en las muertes debido al uso de opioides sintéticos y psicoestimulantes. La tasa de muerte inducida por drogas aumentó para todos los grupos de población menos uno: los mayores de 75 años. Hubo aumentos particularmente grandes en las comunidades de color, entre los jóvenes (de 17 años o menos) y los adultos jóvenes (de 18 a 34 años) y en las regiones sur y oeste del país.
o Las tasas de mortalidad inducida por el alcohol aumentaron en un 27 por ciento, y el aumento abarcó grupos demográficos y partes del país, incluidos los 50 estados y el Distrito de Columbia. Los aumentos fueron particularmente altos entre los adultos jóvenes, los indios americanos/nativos de Alaska y las comunidades asiáticas, y entre los que viven en el Medio Oeste.
o Las tasas generales de suicidio disminuyeron en un 3 por ciento, pero esa tendencia no fue universal. La disminución se produjo entre los blancos, pero las muertes por suicidio durante el año aumentaron entre los indios americanos, los negros y los latinos. Las tasas de suicidio de adultos de 35 a 74 años de edad disminuyeron, pero las tasas de jóvenes y adultos jóvenes aumentaron.
“Con las tendencias que continúan yendo en la dirección equivocada, debemos preguntarnos, ¿qué se necesita para pasar a una acción sólida e integral? La historia detrás de estos datos es más que devastadora y desgarradora para aquellas familias que han sufrido pérdidas”, dijo el Dr. Benjamin F. Miller, presidente de Well Being Trust. “Empecemos a atender esta crisis con la urgencia que se merece llevando atención donde está la gente. Desde las escuelas hasta la atención primaria y nuestros lugares de trabajo, asegurémonos de que todos los lugares estén equipados para abordar la salud mental y el abuso de sustancias. Esta no es solo la responsabilidad del campo de la salud mental y las adicciones, sino toda nuestra responsabilidad”.
TFAH y Well Being Trust han estado informando muertes inducidas por alcohol, drogas y suicidio como parte de su iniciativa Pain in the Nation desde 2018. En el informe inaugural de la iniciativa de 2018, las muertes por alcohol, drogas y suicidio representaron 55,403 muertes por año, en comparación con las 186.763 muertes asociadas con el alcohol, las drogas o el suicidio en el informe de este año. Según los autores del informe y otros expertos, el sorprendente aumento de las muertes por alcohol y drogas en el 2020 se vio exacerbado por: un aumento continuo de las sobredosis de opioides sintéticos y psicoestimulantes y la ansiedad, el estrés, el dolor, la interrupción de los programas de recuperación del abuso de sustancias y las dificultades financieras muchas personas y familias experimentaron durante la pandemia de COVID-19.
El informe incluye recomendaciones sobre los pasos que los gobiernos federal, estatal y local deben tomar para comenzar a revertir la crisis de las muertes por desesperación. Incluyen:
Invertir en programas que promuevan la salud y prevengan el uso indebido de sustancias y el suicidio:
- Apoyar programas en la escuela enfocados en la salud mental de los estudiantes y la prevención del uso de sustancias.
- Fortalecer los programas informados sobre el trauma y culturalmente competentes y lingüísticamente apropiados dentro de todas las agencias que atienden a los jóvenes, incluido el sistema de justicia juvenil.
- Fortalecer la continuidad de los programas de intervención en crisis con un enfoque en la línea de vida “988” recientemente establecida.
- Expandir los esfuerzos integrales de prevención del suicidio de los CDC, incluidas medidas para fortalecer los apoyos económicos, promover la conexión y crear entornos protectores.
- Desarrollar programas que aborden los determinantes sociales de la salud y promuevan la resiliencia en los niños, las familias y las comunidades, incluidos aquellos enfocados en la prevención de experiencias infantiles adversas.
Abordar las crisis de uso indebido y sobredosis de sustancias:
- Promover políticas de reducción de daños para reducir las sobredosis y las infecciones transmitidas por la sangre, incluido el aumento del acceso a programas de servicio de jeringas, naloxona y tiras reactivas de fentanilo.
- Preservar y ampliar los programas que crean un acceso más flexible al tratamiento del trastorno por consumo de sustancias durante la pandemia.
- Financiamiento directo del acuerdo de litigio de opioides para la prevención primaria del abuso de sustancias por parte de los jóvenes.
- Reducir el consumo excesivo de alcohol mediante políticas que limiten dónde y cuándo se puede servir/comprar alcohol y mediante el uso de impuestos especiales sobre el alcohol.
Transformar el sistema de prevención de salud mental y abuso de sustancias
- Aumentar el acceso al tratamiento de salud mental y uso de sustancias a través de la plena aplicación de la Ley de Equidad en Adicción y Paridad en Salud Mental.
- Combatir el estigma sobre los problemas de salud mental y el acceso al servicio.
- Modernizar los servicios de salud física y mental alineando la prestación de servicios, el pago de los proveedores, las medidas de calidad y la capacitación hacia la salud integral de las personas y la atención integrada.
- Desarrollar la capacidad comunitaria de base para la identificación e intervención tempranas de personas con trastornos de salud mental y uso de sustancias, incluso a través de entornos comunitarios o no tradicionales.
“Es imperativo que los funcionarios de todos los niveles del gobierno actúen sobre las políticas recomendadas en este informe. Los datos son sorprendentemente claros: las vidas corren peligro en todas las comunidades debido al alcohol, las drogas y el suicidio, y las comunidades que experimentan desventajas debido a las desigualdades sociales, económicas y ambientales de larga data sufren un impacto desproporcionado. Existe una necesidad urgente de actuar para salvar vidas”, dijo J. Nadine Gracia, presidenta y directora ejecutiva de Trust for America’s Health.
Lea el informe completo
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Trust for America’s Health es una organización no partidista y sin fines de lucro que promueve la salud óptima para cada persona y comunidad y hace de la prevención de enfermedades y lesiones una prioridad nacional.
Well Being Trust es una filantropía de impacto dedicada a promover la salud mental, social y espiritual de la nación.
U.S. Drug Overdose Deaths Increased by 31 Percent in 2020; Up 56 Percent for Synthetic Opioids
(Washington, DC – January 4, 2022) According to a National Center for Health Statistics report released the last week of 2021 using official annual mortality data, 91,799 Americans died from drug overdoses in 2020. This is an astounding 31 percent increase over the 2019 rate and the largest year-over-year rate increase on record. Additional data suggests that 2021 drug overdose deaths continued to increase, underscoring the negative impact the COVID-19 pandemic has had on the health and well-being of Americans.
The increases in drug deaths occurred nationally, spanning age, sex, and racial/ethnic groups. In both 2019 and 2020, the highest overdose deaths rates were for American Indian/Alaska Native people and the largest percentage increase in drug overdose death rates from 2019 to 2020 were seen in Black and Native Hawaiian/Other Pacific Islander people. These data show again the urgent need for comprehensive action to address the nation’s growing substance misuse crisis among diverse populations.
Additional analysis by Trust for America’s Health (TFAH) and Well Being Trust (WBT) of state-level data show nearly all states and the District of Columbia saw increases between 2019 and 2020, including very large ones for many states.
- Five states—Kentucky, Louisiana, Mississippi, South Carolina, and West Virginia—had drug overdose death rates that increased by more than 50 percent between 2019 and 2020.
- Just seven states had increases under 10 percent, including three states (Delaware, New Hampshire, and South Dakota) that saw declines.
“The long-term and recent trends in drug overdoses are alarming, and require more attention from policymakers,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “As we continue to respond to and work to recover from the pandemic, we must take a comprehensive approach that includes policies and programs that reduce overdoses and help Americans suffering from addiction. Policies that address social, economic, and environmental disadvantage, such as childhood trauma, poverty, and discrimination, are needed to help change the trajectory of alcohol, drug, and suicide deaths in the coming decades.”
Over the last five years, TFAH and WBT have released as series of reports on “deaths of despair” called Pain in the Nation: The Drug, Alcohol and Suicides Epidemics and the Need for a National Resilience Strategy, which include data analysis and recommendations for evidence-based policies and programs that federal, state, and local officials. The 2022 Pain in the Nation report will be released in May.
“This comes down to leadership and action. If we don’t move to do something now, these terrible trends will only continue,” said Benjamin F. Miller, PsyD, President of Well Being Trust. “The data are clear— we need to move beyond talk and push for programs and policies that work; and, we need to do so in a way that recognizes that all communities are different and each are going to benefit from a more tailored approach to address this massive problem.”
Key findings by drug-type from the recent NCHS report include:
- Overall drug overdoses deaths: 91,799 Americans died from drug overdoses in 2020, a rate of 28.3 deaths per 100,000 people. This is a rate 31 percent higher than over 2019 when 70,630 Americans died of drug overdoses (21.6 deaths per 100,000).
- Opioid overdose deaths: 68,630 Americans died from opioid overdoses in 2020, a rate of 21.4 deaths per 100,000 people. This is a rate 38 percent higher than 2019 when 49,860 Americans died of opioid overdoses (15.5 deaths per 100,000).
- Synthetic opioid overdose deaths: 56,516 Americans died from synthetic opioid overdoses in 2020, a rate of 17.8 deaths per 100,000 people. That is a rate 56 percent higher than 2019, when 36,359 Americans died of synthetic opioids overdoses (11.4 deaths per 100,000). The rate of synthetic opioid overdose deaths has increased more than fivefold over the past five years.
- Cocaine overdose deaths: 19,447 Americans died from cocaine overdoses in 2020, a rate of 6.0 deaths per 100,000 people. That rate is 22 percent higher than 2019, when 15,883 Americans died of cocaine overdoses (4.9 deaths per 100,000). The rate of cocaine overdose deaths has increased by almost threefold over the past five years.
- Psychostimulant overdose deaths: 23,837 Americans died from psychostimulants in 2020, a rate of 7.5 deaths per 100,000 people. That’s a rate 50 percent higher than 2019, when 16,167 Americans died from psychostimulant overdoses (5.0 deaths per 100,000). The rate of psychostimulants overdose death has increased by fourfold over the past five years.
Additional annual, racial/ethnic, and state-level data can be found below.
Drug Overdose Deaths, 1999-2020
| Year | Deaths | Deaths per 100,000 (Age Adjusted) |
| 1999 | 16,849 | 6.1 |
| 2000 | 17,415 | 6.2 |
| 2001 | 19,394 | 6.8 |
| 2002 | 23,518 | 8.2 |
| 2003 | 25,785 | 8.9 |
| 2004 | 27,424 | 9.4 |
| 2005 | 29,813 | 10.1 |
| 2006 | 34,425 | 11.5 |
| 2007 | 36,010 | 11.9 |
| 2008 | 36,450 | 11.9 |
| 2009 | 37,004 | 11.9 |
| 2010 | 38,329 | 12.3 |
| 2011 | 41,340 | 13.2 |
| 2012 | 41,502 | 13.1 |
| 2013 | 43,982 | 13.8 |
| 2014 | 47,055 | 14.7 |
| 2015 | 52,404 | 16.3 |
| 2016 | 63,632 | 19.8 |
| 2017 | 70,237 | 21.7 |
| 2018 | 67,367 | 20.7 |
| 2019 | 70,630 | 21.6 |
| 2020 | 91,799 | 28.3 |
Source: National Vital Statistics System, National Center for Health Statistics
Drug Overdose Deaths by Racial/Ethnic Groups, 2019-2020
| Racial/Ethnic Group | 2019 Deaths | 2019 Deaths Per 100,000 (Age Adjusted) | 2020 Deaths | 2020 Deaths Per 100,000 (Age Adjusted) | Change in Death Rate, 2019–2020 |
| Non-Hispanic White | 50,044 | 26.2 | 62,312 | 33.1 | 26% |
| Non-Hispanic Black | 10,517 | 24.8 | 15,256 | 35.8 | 44% |
| Non-Hispanic American Indian/ Alaska Native | 723 | 30.5 | 1,009 | 42.5 | 39% |
| Non-Hispanic Asian | 679 | 3.3 | 935 | 4.6 | 39% |
| Non-Hispanic Native Hawaiian/ Other Pacific Islander | 58 | 9.5 | 86 | 13.7 | 44% |
| Hispanic | 7,473 | 12.7 | 10,606 | 17.6 | 39% |
Source: National Vital Statistics System, National Center for Health Statistics
Drug Overdose Deaths by State, 2019-2020
| State | 2019 Deaths | 2019 Deaths Per 100,000 (Age Adjusted) | 2020 Deaths | 2020 Deaths Per 100,000 (Age Adjusted) | Change in Death Rate, 2019–2020 |
| Alabama | 768 | 16.3 | 1029 | 22.3 | 37% |
| Alaska | 132 | 17.8 | 160 | 22.0 | 24% |
| Arizona | 1907 | 26.8 | 2550 | 35.8 | 33% |
| Arkansas | 388 | 13.5 | 546 | 19.1 | 41% |
| California | 6198 | 15.0 | 8908 | 21.8 | 46% |
| Colorado | 1079 | 18.0 | 1492 | 24.9 | 38% |
| Connecticut | 1214 | 34.7 | 1371 | 39.1 | 13% |
| Delaware | 435 | 48.0 | 444 | 47.3 | -2% |
| D.C. | 311 | 43.2 | 424 | 58.1 | 34% |
| Florida | 5268 | 25.5 | 7231 | 35.0 | 37% |
| Georgia | 1408 | 13.1 | 1916 | 18.0 | 38% |
| Hawaii | 242 | 15.9 | 274 | 18.3 | 15% |
| Idaho | 265 | 15.1 | 287 | 15.9 | 5% |
| Illinois | 2790 | 21.9 | 3549 | 28.1 | 28% |
| Indiana | 1699 | 26.6 | 2321 | 36.7 | 38% |
| Iowa | 352 | 11.5 | 432 | 14.3 | 25% |
| Kansas | 403 | 14.3 | 490 | 17.4 | 22% |
| Kentucky | 1380 | 32.5 | 2083 | 49.2 | 51% |
| Louisiana | 1267 | 28.3 | 1896 | 42.7 | 51% |
| Maine | 371 | 29.9 | 496 | 39.7 | 33% |
| Maryland | 2369 | 38.2 | 2771 | 44.6 | 17% |
| Massachusetts | 2210 | 32.1 | 2302 | 33.9 | 6% |
| Michigan | 2385 | 24.4 | 2759 | 28.6 | 17% |
| Minnesota | 792 | 14.2 | 1050 | 19.0 | 34% |
| Mississippi | 394 | 13.6 | 586 | 21.1 | 55% |
| Missouri | 1583 | 26.9 | 1875 | 32.1 | 19% |
| Montana | 143 | 14.1 | 162 | 15.6 | 10% |
| Nebraska | 161 | 8.7 | 214 | 11.3 | 30% |
| Nevada | 647 | 20.1 | 832 | 26.0 | 29% |
| New Hampshire | 407 | 32.0 | 393 | 30.3 | -5% |
| New Jersey | 2805 | 31.7 | 2840 | 32.1 | 1% |
| New Mexico | 599 | 30.2 | 784 | 39.0 | 29% |
| New York | 3617 | 18.2 | 4965 | 25.4 | 39% |
| North Carolina | 2266 | 22.3 | 3146 | 30.9 | 39% |
| North Dakota | 82 | 11.4 | 114 | 15.6 | 37% |
| Ohio | 4251 | 38.3 | 5204 | 47.2 | 23% |
| Oklahoma | 645 | 16.7 | 762 | 19.4 | 17% |
| Oregon | 615 | 14.0 | 803 | 18.7 | 34% |
| Pennsylvania | 4377 | 35.6 | 5168 | 42.4 | 19% |
| Rhode Island | 307 | 29.5 | 397 | 38.2 | 29% |
| South Carolina | 1127 | 22.7 | 1739 | 34.9 | 54% |
| South Dakota | 86 | 10.5 | 83 | 10.3 | -2% |
| Tennessee | 2089 | 31.2 | 3034 | 45.6 | 46% |
| Texas | 3136 | 10.8 | 4172 | 14.1 | 31% |
| Utah | 571 | 18.9 | 622 | 20.5 | 8% |
| Vermont | 133 | 23.8 | 190 | 32.9 | 38% |
| Virginia | 1547 | 18.3 | 2240 | 26.6 | 45% |
| Washington | 1259 | 15.8 | 1733 | 22.0 | 39% |
| West Virginia | 870 | 52.8 | 1330 | 81.4 | 54% |
| Wisconsin | 1201 | 21.1 | 1531 | 27.7 | 31% |
| Wyoming | 79 | 14.1 | 99 | 17.4 | 23% |
Source: TFAH and WBT analysis of data from the National Center for Health Statistics
Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. www.tfah.org Twitter:@HealthyAmerica1
Well Being Trust is a national foundation dedicated to advancing the mental, social, and spiritual health of the nation. Created to include participation from organizations across sectors and perspectives, Well Being Trust is committed to innovating and addressing the most critical mental health challenges facing America, and to transforming individual and community well-being. www.wellbeingtrust.org. Twitter: @WellBeingTrust